WorldWideScience

Sample records for ontario osteoporosis strategy

  1. The Ontario Osteoporosis Strategy: implementation of a population-based osteoporosis action plan in Canada.

    Science.gov (United States)

    Jaglal, S B; Hawker, G; Cameron, C; Canavan, J; Beaton, D; Bogoch, E; Jain, R; Papaioannou, A

    2010-06-01

    In the last decade, there have been a number of action plans published to highlight the importance of preventing osteoporosis and related fractures. In the province of Ontario Canada, the Ministry of Health provided funding for the Ontario Osteoporosis Strategy. The goal is to reduce morbidity, mortality, and costs from osteoporosis and related fractures through an integrated and comprehensive approach aimed at health promotion and disease management. This paper describes the components of the Ontario Osteoporosis Strategy and progress on implementation efforts as of March 2009. There are five main components: health promotion; bone mineral density testing, access, and quality; postfracture care; professional education; and research and evaluation. Responsibility for implementation of the initiatives within the components is shared across a number of professional and patient organizations and academic teaching hospitals with osteoporosis researchers. The lessons learned from each phase of the development, implementation, and evaluation of the Ontario Osteoporosis Strategy provides a tremendous opportunity to inform other jurisdictions embarking on implementing similar large-scale bone health initiatives.

  2. Strategies to overcome barriers to implementing osteoporosis and fracture prevention guidelines in long-term care: a qualitative analysis of action plans suggested by front line staff in Ontario, Canada.

    Science.gov (United States)

    Alamri, Sultan H; Kennedy, Courtney C; Marr, Sharon; Lohfeld, Lynne; Skidmore, Carly J; Papaioannou, Alexandra

    2015-08-01

    Osteoporosis is a major global health problem, especially among long-term care (LTC) facilities. Despite the availability of effective clinical guidelines to prevent osteoporosis and bone fractures, few LTC homes actually adhere to these practical recommendations. The purpose of this study was to identify barriers to the implementation of evidence-based practices for osteoporosis and fracture prevention in LTC facilities and elicit practical strategies to address these barriers. We performed a qualitative analysis of action plans formulated by Professional Advisory Committee (PAC) teams at 12 LTC homes in the intervention arm of the Vitamin D and Osteoporosis Study (ViDOS) in Ontario, Canada. PAC teams were comprised of medical directors, administrators, directors of care, pharmacists, dietitians, and other staff. Thematic content analysis was performed to identify the key themes emerging from the action plans. LTC teams identified several barriers, including lack of educational information and resources prior to the ViDOS intervention, difficulty obtaining required patient information for fracture risk assessment, and inconsistent prescribing of vitamin D and calcium at the time of admission. The most frequently suggested recommendations was to establish and adhere to standard admission orders regarding vitamin D, calcium, and osteoporosis therapies, improve the use of electronic medical records for osteoporosis and fracture risk assessment, and require bone health as a topic at quarterly reviews and multidisciplinary conferences. This qualitative study identified several important barriers and practical recommendations for improving the implementation of osteoporosis and fracture prevention guidelines in LTC settings.

  3. Global warming: Towards a strategy for Ontario

    International Nuclear Information System (INIS)

    1990-01-01

    A discussion paper is provided as background to a proposed public review of a strategy for Ontario's response to global warming. Global warming arises from the generation of greenhouse gases, which come from the use of fossil fuels, the use of chlorofluorocarbons, and deforestation. Energy policy is the backbone of achieving climate stability since the burning of fossil fuels releases most of the greenhouse gases, mainly carbon dioxide. Canada is, by international standards, a very energy-intensive country and is among the world's largest emitters of carbon dioxide on a per capita basis. Ontario is the largest energy-using province in Canada, and fossil fuels represent over 80% of provincial energy use. A proposed goal for Ontario is to provide leadership in stabilizing atmospheric concentrations of the greenhouse gases, while minimizing the social, economic, and environmental costs in Ontario of adapting to global warming. A proposed first step to address global warming is to achieve reductions in expected emissions of the greenhouse gases, especially carbon dioxide, so that levels by the year 2000 are lower than in 1989. Current policies and regulations helping to reduce the greenhouse effect include some of the current controls on automotive emissions and the adoption by the provincial electric utility of targets to reduce electricity demand. New initiatives include establishment of minimum energy efficiency standards and reduction of peak-day electricity use. Action steps for future consideration are detailed in the categories of greenhouse gas emissions reductions, carbon dioxide absorption, and research and analysis into global warming

  4. Local strategies to prevent and treat osteoporosis.

    Science.gov (United States)

    Torstrick, F Brennan; Guldberg, Robert E

    2014-03-01

    Despite advances in systemic osteoporosis therapeutic outcomes, management of fragility fractures and implant fixation in osteoporotic bone remain difficult clinical challenges. Low initial bone density and a prolonged healing response can lead to fracture nonunion and aseptic implant loosening. Local treatment strategies could be used to prevent fracture, accelerate healing, and increase implant fixation by locally stimulating anabolic pathways or inhibiting catabolic pathways. Local strategies under investigation include direct drug release from injectable materials or implant surface coatings. Common locally delivered drugs include bisphosphonates, parathyroid hormone, and bone morphogenetic proteins, yet additional compounds targeting novel pathways in bone biology are also being actively explored. Mechanical stimulation via low intensity pulsed ultrasound, alone or in combination with drug therapy, may also prove effective to promote local bone healing and implant fixation within osteoporotic bone.

  5. Gas marketing strategies for Ontario producers

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, P.R. [Energy Objective Ltd., London, ON (Canada)

    2000-07-01

    Activity in natural gas exploration and production in the province of Ontario has recently increased due to higher natural gas prices. This paper discussed the issue of how the gas from the new reserves should be marketed. A review of historical pricing and consumption patterns was also presented to better identify how prices of natural gas are determined in Ontario and to forecast the future demand for natural gas. The first trend of interest is the increased use of natural gas in generating electricity to meet cooling needs in the summer months. The second trend is the increase in gas consumption by the industrial sector resulting from increases in process load. Several marketing options are available to Ontario natural gas producers. They can market their gas to third parties at various trading points in the province or they can market it directly to Union Gas Limited, the local gas utility. This paper briefly described how a gas supply contract works with the union, how gas marketing agreement is conducted with a gas marketer, and how a gas marketing arrangement works with a consultant. Some of the pitfalls of marketing natural gas were also described and some recommended some strategies for selling natural gas in the future were presented. 7 figs.

  6. Gas marketing strategies for Ontario producers

    International Nuclear Information System (INIS)

    Walsh, P.R.

    2000-01-01

    Activity in natural gas exploration and production in the province of Ontario has recently increased due to higher natural gas prices. This paper discussed the issue of how the gas from the new reserves should be marketed. A review of historical pricing and consumption patterns was also presented to better identify how prices of natural gas are determined in Ontario and to forecast the future demand for natural gas. The first trend of interest is the increased use of natural gas in generating electricity to meet cooling needs in the summer months. The second trend is the increase in gas consumption by the industrial sector resulting from increases in process load. Several marketing options are available to Ontario natural gas producers. They can market their gas to third parties at various trading points in the province or they can market it directly to Union Gas Limited, the local gas utility. This paper briefly described how a gas supply contract works with the union, how gas marketing agreement is conducted with a gas marketer, and how a gas marketing arrangement works with a consultant. Some of the pitfalls of marketing natural gas were also described and some recommended some strategies for selling natural gas in the future were presented. 7 figs

  7. Implications of the Ontario government's white paper and competition strategies for Ontario's municipal electric utilities

    International Nuclear Information System (INIS)

    Wills, D.L.

    1998-01-01

    The strategies that Municipal Electric Utilities (MEU) should follow to deal with competition were discussed. North Bay Hydro is the 34th largest MEU out of 300 in Ontario but it serves only 23,000 out of 4 million electrical customers in Ontario. Therefore, the main strategy for municipal utilities to ensure their future would be to become part of an alliance and association like the MEA and the SAC - the Strategic Alliance for Competition and Customer Choice. Strong criticism was voiced regarding the contents of the recent Ontario Government White Paper for being vague with regard to electrical distribution and the role of MEUs in Ontario. It was suggested that it is vitally important that MEUs ally themselves with other stakeholders, to resist an Ontario Hydro monopoly, to make sure that prices stay low, to avoid excessive debt and bureaucratic inefficiency, be innovative, and consumer oriented and be prepared to anticipate events and conditions. 3 figs

  8. The Risk-Stratified Osteoporosis Strategy Evaluation study (ROSE)

    DEFF Research Database (Denmark)

    Rubin, Katrine Hass; Holmberg, Teresa; Rothmann, Mette Juel

    2015-01-01

    The risk-stratified osteoporosis strategy evaluation study (ROSE) is a randomized prospective population-based study investigating the effectiveness of a two-step screening program for osteoporosis in women. This paper reports the study design and baseline characteristics of the study population....... 35,000 women aged 65-80 years were selected at random from the population in the Region of Southern Denmark and-before inclusion-randomized to either a screening group or a control group. As first step, a self-administered questionnaire regarding risk factors for osteoporosis based on FRAX......(®) was issued to both groups. As second step, subjects in the screening group with a 10-year probability of major osteoporotic fractures ≥15 % were offered a DXA scan. Patients diagnosed with osteoporosis from the DXA scan were advised to see their GP and discuss pharmaceutical treatment according to Danish...

  9. Nuclear cluster strategy Carolinas - Ontario - Saskatchewan

    International Nuclear Information System (INIS)

    Oberth, R.

    2012-01-01

    Organization of Candu Industries (OCI) is an industry association representing the interests of 170 private sector suppliers of products and services to the Canadian and offshore nuclear industries. OCI member companies, mainly in Ontario, employ over 30,000 highly specialized workers with over 12,000 working in nuclear area. OCI's objectives are to sustain the domestic nuclear program by building support among political leaders, the public and local communities, assist OCI member companies in becoming the preferred suppliers for domestic nuclear projects (competitive), assist OCI member companies in international nuclear markets - trade missions and vendor workshops. OCI is at the heart of an 'Ontario nuclear cluster'. The Carolinas have shown what can be achieved when industry, academia, S&T centers and governments collaborate with a shared vision to achieve a common goals. Ontario has the assets to become a stronger center for nuclear excellence. OCI is working to bring the pieces together. Saskatchewan has the assets to become a center of excellence in Small Modular Reactors (SMR) by licensing and constructing the first SMR in Canada.

  10. Osteoporosis

    Science.gov (United States)

    ... bearing exercises such as walking, jogging, playing tennis, dancing Free weights, weight machines, stretch bands Balance exercises ... 27759931 www.ncbi.nlm.nih.gov/pubmed/27759931 . Black DM, Rosen CJ. Clinical practice: postmenopausal osteoporosis. N ...

  11. Women’s perspectives and experiences on screening for osteoporosis (Risk-stratified Osteoporosis Strategy Evaluation, ROSE)

    DEFF Research Database (Denmark)

    Rothmann, Mette Juel; Huniche, Lotte; Ammentorp, Jette

    2014-01-01

    main themes: knowledge about osteoporosis, psychological aspects of screening, and moral duty. The women viewed the program in the context of their everyday life and life trajectories. Age, lifestyle, and knowledge about osteoporosis were important to how women ascribed meaning to the program, how......This study aimed to investigate women's perspectives and experiences with screening for osteoporosis. Focus groups and individual interviews were conducted. Three main themes emerged: knowledge about osteoporosis, psychological aspects of screening, and moral duty. Generally, screening was accepted...... due to life experiences, self-perceived risk, and the preventive nature of screening. PURPOSE: The risk-stratified osteoporosis strategy evaluation (ROSE) study is a randomized prospective population-based trial investigating the efficacy of a screening program to prevent fractures in women aged 65...

  12. Ontario's Poverty Reduction Strategy: A Critical Discourse Analysis.

    Science.gov (United States)

    Benbow, Sarah; Gorlick, Carolyne; Forchuk, Cheryl; Ward-Griffin, Catherine; Berman, Helene

    2016-01-01

    This article overviews the second phase of a two-phase study which examined experiences of health and social exclusion among mothers experiencing homelessness in Ontario, Canada. A critical discourse analysis was employed to analyze the policy document, Realizing Our Potential: Ontario's Poverty Reduction Strategy, 2014-2019. In nursing, analysis of policy is an emerging form of scholarship, one that draws attention to the macro levels influencing health and health promotion, such as the social determinants of health, and the policies that impact them. The clear neo-liberal underpinnings, within the strategy, with a focus on productivity and labor market participation leave little room for an understanding of poverty reduction from a human rights perspective. Further, gender-neutrality rendered the poverty experienced by women, and mothers, invisible. Notably, there were a lack of deadlines, target dates, and thorough action and evaluation plans. Such absence troubles whether poverty reduction is truly a priority for the government, and society as a whole.

  13. Osteoporosis

    OpenAIRE

    Nolla, Joan Miquel

    2006-01-01

    La osteoporosis se define como un trastorno esquelético caracterizado por un compromiso de la resistencia ósea, que predispone a un mayor riesgo de fractura. La resistencia refleja la integración de la masa ósea y de la calidad del hueso. La masa ósea (densidad mineral ósea), que se puede evaluar de forma objetiva mediante las técnicas de densitometría, explica alrededor del 70% de la resistencia del hueso. Conceptualmente, la masa ósea que posee una persona en un momento determinado depende ...

  14. [Physiotherapy strategies in osteoporosis--recommendations for daily practice].

    Science.gov (United States)

    Uhlemann, C; Lange, U

    2006-09-01

    Physiotherapy in osteoporosis essentially takes the form of stimulatory therapy tailored to the findings and the pathomechanism. The choice of therapy and its dosage depend on the desired result (prevention, cure, rehabilitation). Physical therapy applied in osteoporosis includes electrical, thermic (hydrothermic, high frequency thermic, light thermic) and mechanical (massage, physiotherapy) stimuli, which can be applied regionally, locally or hoistically. To be efficient, a pain therapy requires that the various painful states be differentiated between: whereas, for example, in the case of acute pain physiotherapy fulfils the function of immediate therapy (normally rest and "mild" cold applications), in chronic pain it has to fulfil the function of an adaptive performance therapy of neuronal structures (formative-adaptive physiotherapy, thermic therapy improving trophism, direct current, transcutaneous electric nerve stimulation/TENS). It is necessary and extremely important forday-to-day clinical practice that physiotherapy strategies that are tailored to each patient's needs and also economically justifiable be implemented. The article isintended to contribute to this.

  15. Osteoporosis Prevention—A Worthy and Achievable Strategy

    Directory of Open Access Journals (Sweden)

    Howard A. Morris

    2010-10-01

    Full Text Available This special issue of Nutrients records seven of the presentations made to the very successful meeting titled “Osteoporosis Prevention: A Workshop on Calcium, Vitamin D and other Nutritional Aspects” held in Adelaide, Australia on 5 and 6 March 2010 [1-7]. Seventy six delegates attended from across Australia and New Zealand to review the current evidence that dietary calcium intake, vitamin D status, other nutrients and exercise play a significant role in bone mineral homeostasis and act to prevent the development of osteoporosis. The Workshop promoted the concept that osteoporosis is a predictable and preventable disease and that significant benefit would be achieved to reduce the incidence of osteoporosis and the risk of fractures from nutrition and life style activities. Such an achievement will not only save considerable pain, suffering and morbidity but will also have a major financial benefit for the healthcare system for which the cost of treatment for osteoporotic fractures already amounts to billions of dollars.

  16. Clinical strategies to address patients' concerns in osteoporosis management with bisphosphonates.

    Science.gov (United States)

    Cole, Raymond E

    2011-03-01

    Approximately 44 million Americans either have, or are at risk of developing, osteoporosis, a disease associated with an increased risk of fracture and, consequently, morbidity and mortality. Osteoporosis affects 20% to 30% of postmenopausal women, and resulting fractures pose a major economic burden, with estimated annual direct costs ranging from $17 billion to $19 billion. Hip fractures account for the majority of costs (~60%) because they often require costly long-term follow-up care in addition to the direct costs of initial treatment. Screening, diagnosis, and disease management are of paramount importance when treating patients at risk for osteoporosis. The National Osteoporosis Foundation recommends that all postmenopausal women be evaluated for osteoporosis risk factors and that all women aged ≥ 65 years undergo bone mineral density testing. Once the primary care physician has identified a patient at risk for osteoporosis-related fracture, the physician must decide whether and how to treat the patient (ie, nonpharmacologic or pharmacologic options). Bisphosphonates are the first-line pharmacologic treatment for women aged ≥ 50 years with postmenopausal osteoporosis. Bisphosphonates-which have a favorable safety and tolerability profile in clinical trials-have shown efficacy in reducing fractures. However, achieved real world effectiveness is very much dependent on good treatment adherence by the patient. Media attention to rare adverse events has motivated some patients to deliberate nonadherence. Physicians should screen patients for contraindications and adverse event risk factors, educate them on the risks of fracture and benefits and risks of treatment, and monitor them during therapy. To assist primary care physicians in clinical decision making for women at risk for or with confirmed osteoporosis, this article presents a review of the guidelines for the diagnosis and treatment of postmenopausal osteoporosis, recent long-term efficacy data for

  17. Osteodensitometry and osteoporosis. Current concepts and strategies for the future

    International Nuclear Information System (INIS)

    Restrepo U, Santiago

    1991-01-01

    The osteoporosis is a disease of universal distribution that affects millions of adults in the whole world, producing a high number of fractures, due to insufficiency that generates a significant morbidity and mortality. This condition is especially frequent in post menopause women. Some concepts about the bone structure, and the principal characteristics of the different methods to quantify the bone mass (conventional radiology, radiogrametry, photo densitometry, single photon absorbitometry, dual photon absorbitometry are reviewed. Finally, the advantages, disadvantages, levels of sensibility, precision, of the different techniques are established. An emphasis is made on the special capacity of the quantitative computed axial tomography to detect as a selective way the alterations of the spongiest bone

  18. (Non)Construction of the Teacher: An Inquiry into Ontario's Equity and Inclusive Education Strategy

    Science.gov (United States)

    Naimi, Kevin; Cepin, Jeanette

    2015-01-01

    In this paper we perform a critical discourse analysis on the policy document Ontario's Equity and Inclusive Education Strategy (2009). We examine the three core priorities the policy outlines: improve student achievement, reduce achievement gap and increase public confidence in public education. This document is approached from the context of new…

  19. Expanding exports, increasing smog : Ontario Power Generation's and Hydro One's strategies to continue coal-fired electricity generation in Ontario

    International Nuclear Information System (INIS)

    Gibbons, J.

    2002-06-01

    The production of coal-fired electricity increased by approximately 150 per cent in Ontario between 1995 and 2000. As a result, the smog-causing emissions generated by the five coal-fired power plants operated by Ontario Power Generation caused an increase in smog and worsened air quality in the province as well as affecting air quality as far afield as the Atlantic provinces. Between 2002 and 2005, it is expected that the Pickering and Bruce nuclear plants will be returned to service, making the electricity generated by the coal plants surplus to Ontario's needs. Increasing this surplus are the planned natural gas generating stations. Ontario Power Generation is planning on using this surplus to export it to the United States rather than phasing out its reliance on coal. The increase in exports to the United States Northeast and Midwest is planned with Hydro One, already busy increasing its transmission capacity to the United States by 1,000 megawatt (MW). This plan involves laying 975 MW submarine cable from the Nanticoke Generating Station (operated by Ontario Power Generation) under Lake Erie to Pennsylvania, Ohio, or both states. At the moment, the exports are constrained by the government emissions limits imposed by the Ontario government on sulphur dioxide and nitrogen oxides. This constraint could be removed if Ontario Power Generation decides to pay further for pollution controls for sulphur dioxide and nitrogen oxides at its coal stations. Unfortunately, increasing the exports would also result in emissions increases for 28 other uncapped pollutants such as lead, mercury and arsenic. The author recommended that the Ontario government ban non-emergency coal-fired electricity exports to improve air quality in the province. refs., 8 figs

  20. Strategies for Ontario gas marketers: making cents of it all

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, P.R. [Energy Objective Ltd., London ON (Canada)

    2001-07-01

    The evolution of the natural gas supply, demand and pricing equilibrium is discussed. Prices for natural gas are a function of supply and demand. An analysis of supply and demand forecasting shows a consistent trend to mirror the actual outcome. In the case of price, the forecasts are less consistent and indicate the need for a different approach for choosing an appropriate strategy for price determination. Analysis of price data over the past 30 years indicate that increases in natural gas prices in North America have been strongly correlated with increase in economic growth. Increased economic growth creates an increase in energy demand and a related increase in energy prices. Conversely, decreased economic activity tends to coincide with energy price spikes and subsequent declines in energy prices. These results lead to the conclusion that a successful strategy for long term pricing requires the natural gas marketer to establish the point at which the current price is, relative to the long-term equilibrium between demand, supply and pricing. 12 figs.

  1. Strategies for Ontario gas marketers: making cents of it all

    International Nuclear Information System (INIS)

    Walsh, P.R.

    2001-01-01

    The evolution of the natural gas supply, demand and pricing equilibrium is discussed. Prices for natural gas are a function of supply and demand. An analysis of supply and demand forecasting shows a consistent trend to mirror the actual outcome. In the case of price, the forecasts are less consistent and indicate the need for a different approach for choosing an appropriate strategy for price determination. Analysis of price data over the past 30 years indicate that increases in natural gas prices in North America have been strongly correlated with increase in economic growth. Increased economic growth creates an increase in energy demand and a related increase in energy prices. Conversely, decreased economic activity tends to coincide with energy price spikes and subsequent declines in energy prices. These results lead to the conclusion that a successful strategy for long term pricing requires the natural gas marketer to establish the point at which the current price is, relative to the long-term equilibrium between demand, supply and pricing. 12 figs

  2. Towards a Caribou Habitat Management Strategy for Northwestern Ontario: Running the Gauntlet

    Directory of Open Access Journals (Sweden)

    Gerald D. Racey

    1996-01-01

    Full Text Available A management strategy for woodland caribou (Rangifer tarandus caribou habitat is being developed in northwestern Ontario. This strategy is based upon a set of draft Timber Management Guidelines for the Provision of Woodland Caribou Habitat. These guidelines recommend maintaining a sustainable supply of winter habitat within large tracts of old forest, protecting calving areas and minimizing human disturbance. Due to the large temporal and spatial scale of caribou habitat management, an ecosystem-based approach is recommended. Public response to the strategy shows a strong dichotomy between environmental and utilitarian values among all the major stakeholder groups. The major issues raised by the public include security of industrial wood supply, quality of the knowledge base, level of awareness of caribou, economic impacts on remote communities, concern about environmental impacts and silvicultural know-how. The government is responding to these concerns as the strategy evolves. Current emphasis is placed on increasing awareness of the public, training resource managers in caribou biology, management and habitat planning, implementing interim habitat management prescriptions and studying the potential impact on wood supply. The final direction for a northwestern Ontario strategy to conserve woodland caribou habitat has yet to be decided, although a commitment has been made to strive for the conservation of woodland caribou populations and their habitat.

  3. Effectiveness of a two-step population-based osteoporosis screening program using FRAX: the randomized Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study.

    Science.gov (United States)

    Rubin, K H; Rothmann, M J; Holmberg, T; Høiberg, M; Möller, S; Barkmann, R; Glüer, C C; Hermann, A P; Bech, M; Gram, J; Brixen, K

    2018-03-01

    The Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study investigated the effectiveness of a two-step screening program for osteoporosis in women. We found no overall reduction in fractures from systematic screening compared to the current case-finding strategy. The group of moderate- to high-risk women, who accepted the invitation to DXA, seemed to benefit from the program. The purpose of the ROSE study was to investigate the effectiveness of a two-step population-based osteoporosis screening program using the Fracture Risk Assessment Tool (FRAX) derived from a self-administered questionnaire to select women for DXA scan. After the scanning, standard osteoporosis management according to Danish national guidelines was followed. Participants were randomized to either screening or control group, and randomization was stratified according to age and area of residence. Inclusion took place from February 2010 to November 2011. Participants received a self-administered questionnaire, and women in the screening group with a FRAX score ≥ 15% (major osteoporotic fractures) were invited to a DXA scan. Primary outcome was incident clinical fractures. Intention-to-treat analysis and two per-protocol analyses were performed. A total of 3416 fractures were observed during a median follow-up of 5 years. No significant differences were found in the intention-to-treat analyses with 34,229 women included aged 65-80 years. The per-protocol analyses showed a risk reduction in the group that underwent DXA scanning compared to women in the control group with a FRAX ≥ 15%, in regard to major osteoporotic fractures, hip fractures, and all fractures. The risk reduction was most pronounced for hip fractures (adjusted SHR 0.741, p = 0.007). Compared to an office-based case-finding strategy, the two-step systematic screening strategy had no overall effect on fracture incidence. The two-step strategy seemed, however, to be beneficial in the group of women who were

  4. Making health system performance measurement useful to policy makers: aligning strategies, measurement and local health system accountability in ontario

    NARCIS (Netherlands)

    Veillard, Jeremy; Huynh, Tai; Ardal, Sten; Kadandale, Sowmya; Klazinga, Niek S.; Brown, Adalsteinn D.

    2010-01-01

    This study examined the experience of the Ontario Ministry of Health and Long-Term Care in enhancing its stewardship and performance management role by developing a health system strategy map and a strategy-based scorecard through a process of policy reviews and expert consultations, and linking

  5. Building evaluation capacity in Ontario's public health units: promising practices and strategies.

    Science.gov (United States)

    Bourgeois, I; Simmons, L; Buetti, D

    2018-03-26

    This article presents the findings of a project focusing on building evaluation capacity in 10 Ontario public health units. The study sought to identify effective strategies that lead to increased evaluation capacity in the participating organizations. This study used a qualitative, multiple case research design. An action research methodology was used to design customized evaluation capacity building (ECB) strategies for each participating organization, based on its specific context and needs. This methodological approach also enabled monitoring and assessment of each strategy, based on a common set of reporting templates. A multiple case study was used to analyze the findings from the 10 participating organizations and derive higher level findings. The main findings of the study show that most of the strategies used to increase evaluation capacity in public health units are promising, especially those focusing on developing the knowledge, skills, and attitudes of health unit staff and managers. Facilitators to ECB strategies were the engagement of all staff members, the support of leadership, and the existence of organizational tools and infrastructure to support evaluation. It is also essential to recognize that ECB takes time and resources to be successful. The design and implementation of ECB strategies should be based on organizational needs. These can be assessed using a standardized instrument, as well as interviews and staff surveys. The implementation of a multicomponent approach (i.e. several strategies implemented simultaneously) is also linked to better ECB outcomes in organizations. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. [Current prevention and treatment strategies for osteoporosis. Fracture-oriented, effective, low side effects and inexpensive].

    Science.gov (United States)

    Bartl, R; Bartl, C

    2015-12-01

    Osteoporosis is still an underdiagnosed and insufficiently therapied widespread disease in Germany. Of the estimated 7 million osteoporosis patients only 1.5 million receive a guideline conform diagnosis and even less receive appropriate treatment. Some 90 % of patients are provided with analgesics but only 10 % receive an effective therapy, although efficacious, well-tested and affordable medications are available. In addition, approximately one half of the patients terminate treatment after only 1 year although according to the results of recent studies the duration of therapy should be at least 3-5 years. In view of the increasing average life expectancy, a consistent management for prevention of fractures associated with osteoporosis is always most important for society, even if only for reasons of costs. Achievement of this target depends on four circumstances: clarification of the origin of osteoporosis and fractures (bone consciousness), prophylaxis of bone loss and fractures (primary prevention), consistent guideline conform diagnostics and therapy (secondary and tertiary prevention) and cooperation of all disciplines in medicine (bone is everybody's business). This article describes the current state of diagnostics (bone density measurement with dual X-ray absorptiometry, FRAX®), prophylaxis of fractures (screening program) and therapy (use of economic and effective medications with low side effects). Novel medications are already undergoing clinical testing and a "healing" of bone reduction with restoration of the normal bone structure is to be expected.

  7. Symbolic Resources and Marketing Strategies in Ontario Higher Education: A Comparative Analysis

    Science.gov (United States)

    Pizarro Milian, Roger; Davidson, Cliff

    2018-01-01

    Existing research on marketing within PSE tends to focus on homogeneous groups of high-status organisations. This study ameliorates this gap in the literature, conducting a comparative analysis of promotional materials produced by public universities and community colleges in Ontario, Canada. We find that these two groups draw on unique strategies…

  8. Proceedings of the Canadian Institute's Power On conference : the latest strategies to maximize opportunities in Ontario's electricity sector

    International Nuclear Information System (INIS)

    2004-01-01

    This conference provided a forum for reviewing strategies for Ontario's electricity sector with particular reference to electricity sector reform strategies and coal phase-out commitments. A supply adequacy outlook in terms of projected demand growth and generation mix and capacity was presented by the Independent Market Operator (IMO) along with issues concerning rising energy costs in various jurisdictions. Consumer adaptation to new pricing structures was discussed as well as generation investment needs to the year 2020. Government policies and commitments in the electricity sector were reviewed, as well as issues related to emissions and the impacts of air pollution. Renewable energy portfolios were also discussed along with issues concerning infrastructure adequacy. Imports of power and the expansion of transmission capabilities between Ontario and surrounding jurisdictions were reviewed and various opportunities from Manitoba were explored. Other topics of discussion included issues concerning pricing mechanisms; cost recovery; the development of effective buying strategies; and electricity purchasing for large energy consumers. The conference featured 23 presentations, of which 8 have been catalogued separately for inclusion in this database. tabs., figs

  9. Active offer of health services in French in Ontario: Analysis of reorganization and management strategies of health care organizations.

    Science.gov (United States)

    Farmanova, Elina; Bonneville, Luc; Bouchard, Louise

    2018-01-01

    The availability of health services in French is not only weak but also inexistent in some regions in Canada. As a result, estimated 78% of more than a million of Francophones living in a minority situation in Canada experience difficulties accessing health care in French. To promote the delivery of health services in French, publicly funded organizations are encouraged to take measures to ensure that French-language services are clearly visible, available, easily accessible, and equivalent to the quality of services offered in English. This study examines the reorganization and management strategies taken by health care organizations in Ontario that provide health services in French. Review and analysis of designation plans of a sample of health care organizations. Few health care organizations providing services in French have concrete strategies to guarantee availability, visibility, and accessibility of French-language services. Implementation of the active offer of French-language services is likely to be difficult and slow. The Ontario government must strengthen collaboration with health care organizations, Francophone communities, and other key actors participating in the designation process to help health care organizations build capacities for the effective offer of French-language services. Copyright © 2017 John Wiley & Sons, Ltd.

  10. Comparison between the gold standard DXA with calcaneal quantitative ultrasound based-strategy (QUS) to detect osteoporosis in an HIV infected cohort.

    Science.gov (United States)

    Quiros Roldan, Eugenia; Brianese, Nigritella; Raffetti, Elena; Focà, Emanuele; Pezzoli, Maria Chiara; Bonito, Andrea; Ferraresi, Alice; Lanza, Paola; Porcelli, Teresa; Castelli, Francesco

    Osteoporosis represents one of the most frequent comorbidity among HIV patients. The current standard method for osteoporosis diagnosis is dual-energy X-ray absorptiometry. Calcaneal quantitative ultrasound can provide information about bone quality. The aims of this study are to compare these two methods and to evaluate their ability to screen for vertebral fracture. This cross-sectional study was conducted in HIV patients attending the Clinic of Infectious and Tropical Diseases of Brescia during 2014 and who underwent lumbar/femoral dual-energy X-ray absorptiometry, vertebral fracture assessment and calcaneal quantitative ultrasound. The assessment of osteoporosis diagnostic accuracy was performed for calcaneal quantitative ultrasound and for vertebral fracture comparing them with dual-energy X-ray absorptiometry. We enrolled 73 patients and almost 48% of them had osteoporosis with at least one of the method used. Vertebral fracture were present in 27.4%. Among patients with normal bone measurements, we found vertebral fracture in proportion between 10% and 30%. If we used calcaneal quantitative ultrasound method and/or X-ray as screening, the percentages of possible savable dual-energy X-ray absorptiometry ranged from 12% to 89% and misclassification rates ranged from 0 to 24.6%. A combined strategy, calcaneal quantitative ultrasound and X-Ray, identified 67% of patients with low risk of osteoporosis, but 16.4% of patients were misclassified. We observed that patients with osteoporosis determined by calcaneal quantitative ultrasound and/or dual-energy X-ray absorptiometry have higher probability to undergo vertebral fracture, but neither of them can be used for predicting vertebral fracture. Use of calcaneal quantitative ultrasound for screening is a reasonable alternative of dual-energy X-ray absorptiometry since our study confirm that none strategy is clearly superior, but both screen tools must be always completed with X-ray. Copyright © 2017 Sociedade

  11. Insight conference reports : Smart meters in Ontario : implementation plan and its impact on electricity pricing strategy

    International Nuclear Information System (INIS)

    2005-01-01

    This conference was attended by major players involved in the development and implementation of smart readers. In response to the Ontario Government's plan to install smart meters for all electricity customers in Ontario by 2010, local distribution companies (LDCs) will have to develop programs to select, purchase, install and maintain these new meters. In addition, each LDC will have to develop an approach to collect, aggregate and include electricity consumption, historical data and cost on customer bills. The objective for implementing smart meters is to help consumers control their electricity bills through conservation and demand response. The mandatory technical requirements for smart meters and the support operations of distributors were discussed along with regulatory requirements, impact of legislation on LDCs, centralized versus LDC driven approaches, opportunities for private sector investors, resolving smart meters data management challenges, and new pricing policies. A review of pilot metering programs was presented along with a review of innovative technologies, products and services that can help in choosing, purchasing, installing and maintaining the new meters. tabs., figs

  12. Proceedings of the Canadian Institute's 3. annual conference on generation adequacy in Ontario : strategies to increase capacity to ensure a reliable electricity supply in Ontario

    International Nuclear Information System (INIS)

    2006-01-01

    This conference provided a forum for the discussion of issues related to generation adequacy in Ontario. Members of the electricity industry as well as members from governmental and non-governmental agencies discussed a variety of recommendations for cost-effective reliable energy in Ontario. Issues related to the overhaul or replacement of nuclear power reactors and coal-fired generators in the province were reviewed. The status of various wind power projects in the province was examined along with issues related to interconnected power systems. Best practices for the planning and execution of electricity infrastructure projects were also reviewed, and issues related to stakeholder involvement in electricity generation projects were discussed. The discussions also described recent developments in electricity generation in various jurisdictions in Canada and the United States. The conference featured 19 presentations, of which 7 have been catalogued separately for inclusion in this database. tabs., figs

  13. [Postmenopausal osteoporosis].

    Science.gov (United States)

    László, Adám

    2004-01-04

    Due to its incidence and clinical consequences osteoporosis followed by vertebral, hip, and forearm fractures represents an outstanding problem of nowadays' health care. Because of its high mortality rate hip fractures are of special interest. The number of fractures caused by postmenopausal osteoporosis increases with age. Costs of examinations and treatment of women with postmenopausal osteoporosis and fractures are also increasing and represent a significant amount all over the world. Organization of Osteoporosis Centres in Hungary was founded in 1995 and has been since functioning, however, only the one-sixth of osteoporotic patients are treated. Several risk factors are known in the pathogenesis of osteoporosis, first of all the lack of sufficient calcium and vitamin D intake, age, genetic factors, and circumstances known to predispose falling. Estrogen deficiency is the most likely cause of postmenopausal osteoporosis. Osteodensitometry by DEXA is the most important method to evaluate osteoporosis, since decrease in bone mineral density strongly correlates with fracture incidence. Physical, radiologic, and laboratory examination are also required at the first visit and during follow-up. The quantity of bone can hardly be influenced after the 35th year of age, thus prevention of osteoporosis has special significance: appropriate calcium and vitamin D supplementation, weight-bearing sports and physical activity can prevent fractures. According to the results from studies fulfilling the criteria of evidence-based medicine, first choice treatment of osteoporosis involves hormone replacement therapy, bisphosphonates, the tissue specific tibolone, raloxifen and calcitonin. Calcium and vitamin D supplementation are always necessary to be added to any antiporotic treatment. Other combinations of different antiporotic drugs are useless and make the treatment more expensive. Other treatments like massage, physiotherapy, hip-protecting pants, etc. as well as

  14. CO sub 2 induced climate change in Ontario: Interdependencies and resource strategies. Changement climatique cause par le CO sub 2 en Ontario: Interdependances et strategies en matiere de ressources

    Energy Technology Data Exchange (ETDEWEB)

    1988-01-01

    A summary is presented of a workshop held in November 1985 which was convened to extend the results of an earlier study on the effect of CO{sub 2}-induced climate change on specific components of the air-water-land biota systems and resource uses in Ontario. The workshop examined the interdependencies of those impact sectors and possible resource and socio-economic strategies to mitigate the effects of climate change. Impacts on such matters as streamflow, water quality, wetlands, snowfall, solar energy, municipal water use, hydroelectric power, tourism and recreation, food production, forest resources, and residential heating requirements were evaluated. It was found that almost all components of the climate system and resource use were affected by CO{sub 2}-induced warming, but the nature and magnitude of these impacts vary considerably across resource sectors and are intricately interdependent. Direct impacts are driven by changes in temperature, precipitation, or cloud cover and affect climate system components, and interdependencies among these sectors cause indirect impacts which affect resource use. For example, changes in temperaure and precipitation affect streamflow which indirectly impacts water use, commercial shipping, and recreation. Strategies to mitigate these effects include both preventive and adjustment strategies, some of which require significant forward planning. The timing and pattern of CO{sub 2}-induced change are important in determining the most likely and desirable strategies. A 5-point framework was developed to evaluate strategies and identify research priorities. Among resource and socioeconomic adjustment strategies, research into the forestry sector is of primary importance.

  15. Osteoporosis Overview

    Science.gov (United States)

    ... testosterone level in men can bring on osteoporosis. Anorexia nervosa . Characterized by an irrational fear of weight ... rapid bone loss, and high fracture rates. National nutrition surveys show that many people consume less than ...

  16. Osteoporosis treatment

    DEFF Research Database (Denmark)

    Pazianas, Michael; Abrahamsen, Bo

    2016-01-01

    The findings of the Women's Health Initiative study in 2002 marginalized the use of hormone replacement therapy and established bisphosphonates as the first line of treatment for osteoporosis. Denosumab could be used in selected patients. Although bisphosphonates only maintain the structure of bone...... to their benefits/harm ratio. Treatment of osteoporosis is a long process, and many patients will require treatment with more than one type of drug over their lifetime....

  17. Modelling greenhouse gas emissions for municipal solid waste management strategies in Ottawa, Ontario, Canada

    Energy Technology Data Exchange (ETDEWEB)

    Mohareb, Adrian K. [Technology Early Action Measures (TEAM) Office, 55 Murray Street, Suite 230, Ottawa, ON (Canada); Warith, Mostafa A.; Diaz, Rodrigo [Department of Civil Engineering, Ryerson University, 350 Victoria Street, Toronto, ON (Canada)

    2008-09-15

    Human-induced climate change, through the emission of greenhouse gases, may result in a significant negative impact on Earth. Canada is one of the largest per capita emitters of greenhouse gas, generating 720 megatonnes (Mt) carbon dioxide equivalents (CO{sub 2}e), or per capita emissions of 23.2 t CO{sub 2}e. The solid waste sector in Canada was directly responsible for 25 Mt CO{sub 2}e in 2001, of which 23 Mt CO{sub 2}e were produced by landfill gas (LFG). A modelling exercise was undertaken to determine greenhouse gas (GHG) emissions from the waste sector using the waste disposal, recycling, and composting data from Ottawa, Ontario, Canada for the year 2003, as well as the results of an audit of residential units performed in the same year. This evaluation determined that, among the options examined, waste incineration, further source separation of recyclables, and anaerobic digestion of an organic wastes have the greatest benefits for reducing GHG emissions in the City of Ottawa's waste sector. Challenges surrounding the installation of incineration facilities in Canada suggest that improved diversion of recyclable materials and anaerobic digestion of organic materials are the optimal options for the City of Ottawa to pursue. (author)

  18. Heart and Stroke Foundation of Ontario (HSFO high blood pressure strategy's hypertension management initiative study protocol

    Directory of Open Access Journals (Sweden)

    Von Sychowski Shirley

    2008-12-01

    Full Text Available Abstract Background Achieving control of hypertension prevents target organ damage at both the micro and macrovascular level and is a highly cost effective means of lowering the risk for heart attack and stroke particularly in people with diabetes. Clinical trials demonstrate that blood pressure control can be achieved in a large proportion of people. Translating this knowledge into widespread practice is the focus of the Hypertension Management Initiative, which began in 2004 with the goal of improving the management of this chronic health condition by primary care providers and patients in the community. Methods This study will test the effect of a systems change on the management of high blood pressure in real world practice in primary care in Ontario, Canada. The systems change intervention involves an interprofessional educational program bringing together physicians, nurses and pharmacists with tools for both providers and patients to facilitate blood pressure management. Each of two waves of subjects were enrolled over a 6 month period with the initial enrollment between waves separated by 9 months. Blood pressure will be measured with the BpTru ® automated blood pressure device. To determine the effectiveness of the intervention, a before and after analysis within all subjects will compare blood pressure at baseline to annual measurements for the three year study. To assess whether the intervention has an impact on blood pressure control independent of community trends, a betwen group comparison of baseline blood pressures in the delayed wave will be made with the immediate wave during the same time period, so that the immediate wave has experienced the intervention for at least 9 months. The total enrollment goal is 5,000 subjects. The practice locations include 10 Family Health Teams (FHTs and 1 Community Health Centre (CHC and approximately 49 primary care physicians, 15 nurse practitioners, 37 registered nurses and over 150

  19. Osteoporosis and Hispanic Women

    Science.gov (United States)

    ... Osteoporosis Osteoporosis and Hispanic Women Osteoporosis and Hispanic Women It is a common misconception that osteoporosis only ... seizures. Are There Any Special Issues for Hispanic Women Regarding Bone Health? Several studies indicate a number ...

  20. Secondary osteoporosis.

    Science.gov (United States)

    Boyle, I T

    1993-10-01

    Osteoporosis with attendant increased fracture risk is a common complication of many other diseases. Indeed, almost all chronic diseases make some impact on life-style, usually by restricting physical activity and hence reducing the anabolic effect of exercise and gravitational strains on the skeleton. Restricted appetite and modified gastrointestinal tract function is another commonplace finding that has an impact on bone nutrition and synthesis, as on other systems. Sex hormone status is of particular importance for the maintenance of the normal skeleton, and the postmenopausal woman is at particular risk for most causes of secondary osteoporosis. In dealing with secondary osteoporosis in the hypo-oestrogenic woman, the question of giving hormone replacement therapy in addition to other disease-specific therapy should always be considered, as, for example, in a young amenorrhoeic woman with Crohn's disease. Similarly, in hypogonadal men the administration of testosterone is useful for bone conservation. The wider availability of bone densitometry ought to make us more aware of the presence of osteoporosis in the many disease states discussed above. This is particularly important as the life span of such patients is now increased by improved management of the underlying disease process in many instances. Even in steroid-induced osteoporosis--one of the commonest and most severe forms of osteoporosis--we now have some effective therapy in the form of the bisphosphonates and other anti-bone-resorbing drug classes. The possibility of prophylaxis against secondary osteoporosis has therefore become a possibility, although the very long-term effects of such drug regimens are still unknown. In some situations, such as thyrotoxicosis, Cushing's syndrome and immobilization, spontaneous resolution of at least part of the osteoporosis is possible after cure of the underlying problem. The shorter the existence of the basic problem, the more successful the restoration of the

  1. Identification of recruitment and retention strategies for rehabilitation professionals in Ontario, Canada: results from expert panels.

    Science.gov (United States)

    Tran, Diem; Hall, Linda McGillis; Davis, Aileen; Landry, Michel D; Burnett, Dawn; Berg, Katherine; Jaglal, Susan

    2008-12-09

    Demand for rehabilitation services is expected to increase due to factors such as an aging population, workforce pressures, rise in chronic and complex multi-system disorders, advances in technology, and changes in interprofessional health service delivery models. However, health human resource (HHR) strategies for Canadian rehabilitation professionals are lagging behind other professional groups such as physicians and nurses. The objectives of this study were: 1) to identify recruitment and retention strategies of rehabilitation professionals including occupational therapists, physical therapists and speech language pathologists from the literature; and 2) to investigate both the importance and feasibility of the identified strategies using expert panels amongst HHR and education experts. A review of the literature was conducted to identify recruitment and retention strategies for rehabilitation professionals. Two expert panels, one on Recruitment and Retention and the other on Education were convened to determine the importance and feasibility of the identified strategies. A modified-delphi process was used to gain consensus and to rate the identified strategies along these two dimensions. A total of 34 strategies were identified by the Recruitment and Retention and Education expert panels as being important and feasible for the development of a HHR plan for recruitment and retention of rehabilitation professionals. Seven were categorized under the Quality of Worklife and Work Environment theme, another seven in Financial Incentives and Marketing, two in Workload and Skill Mix, thirteen in Professional Development and five in Education and Training. Based on the results from the expert panels, the three major areas of focus for HHR planning in the rehabilitation sector should include strategies addressing Quality of Worklife and Work Environment, Financial Incentives and Marketing and Professional Development.

  2. Identification of recruitment and retention strategies for rehabilitation professionals in Ontario, Canada: results from expert panels

    Directory of Open Access Journals (Sweden)

    Landry Michel D

    2008-12-01

    Full Text Available Abstract Background Demand for rehabilitation services is expected to increase due to factors such as an aging population, workforce pressures, rise in chronic and complex multi-system disorders, advances in technology, and changes in interprofessional health service delivery models. However, health human resource (HHR strategies for Canadian rehabilitation professionals are lagging behind other professional groups such as physicians and nurses. The objectives of this study were: 1 to identify recruitment and retention strategies of rehabilitation professionals including occupational therapists, physical therapists and speech language pathologists from the literature; and 2 to investigate both the importance and feasibility of the identified strategies using expert panels amongst HHR and education experts. Methods A review of the literature was conducted to identify recruitment and retention strategies for rehabilitation professionals. Two expert panels, one on Recruitment and Retention and the other on Education were convened to determine the importance and feasibility of the identified strategies. A modified-delphi process was used to gain consensus and to rate the identified strategies along these two dimensions. Results A total of 34 strategies were identified by the Recruitment and Retention and Education expert panels as being important and feasible for the development of a HHR plan for recruitment and retention of rehabilitation professionals. Seven were categorized under the Quality of Worklife and Work Environment theme, another seven in Financial Incentives and Marketing, two in Workload and Skill Mix, thirteen in Professional Development and five in Education and Training. Conclusion Based on the results from the expert panels, the three major areas of focus for HHR planning in the rehabilitation sector should include strategies addressing Quality of Worklife and Work Environment, Financial Incentives and Marketing and Professional

  3. The Ontario Food and Nutrition Strategy: identifying indicators of food access and food literacy for early monitoring of the food environment

    OpenAIRE

    Beatrice A. Boucher; Elizabeth Manafò; Meaghan R. Boddy; Lynn Roblin; Rebecca Truscott

    2017-01-01

    Introduction: To address challenges Canadians face within their food environments, a comprehensive, multistakeholder, intergovernmental approach to policy development is essential. Food environment indicators are needed to assess population status and change. The Ontario Food and Nutrition Strategy (OFNS) integrates the food, agriculture and nutrition sectors, and aims to improve the health of Ontarians through actions that promote healthy food systems and environments. This report describes ...

  4. Secondary osteoporosis.

    Science.gov (United States)

    Gennari, C; Martini, G; Nuti, R

    1998-06-01

    Generalized osteoporosis currently represents a heterogeneous group of conditions with many different causes and pathogenetic mechanisms, that often are variably associated. The term "secondary" is applied to all patients with osteoporosis in whom the identifiable causal factors are other than menopause and aging. In this heterogeneous group of conditions, produced by many different pathogenetic mechanisms, a negative bone balance may be variably associated with low, normal or increased bone remodeling states. A consistent group of secondary osteoporosis is related to endocrinological or iatrogenic causes. Exogenous hypercortisolism may be considered an important risk factor for secondary osteoporosis in the community, and probably glucocorticoid-induced osteoporosis is the most common type of secondary osteoporosis. Supraphysiological doses of corticosteroids cause two abnormalities in bone metabolism: a relative increase in bone resorption, and a relative reduction in bone formation. Bone loss, mostly of trabecular bone, with its resultant fractures is the most incapacitating consequence of osteoporosis. The estimated incidence of fractures in patients prescribed corticosteroid is 30% to 50%. Osteoporosis is considered one of the potentially serious side effects of heparin therapy. The occurrence of heparin-induced osteoporosis appeared to be strictly related to the length of treatment (over 4-5 months), and the dosage (15,000 U or more daily), but the pathogenesis is poorly understood. It has been suggested that heparin could cause an increase in bone resorption by increasing the number of differentiated osteoclasts, and by enhancing the activity of individual osteoclasts. Hyperthyroidism is frequently associated with loss of trabecular and cortical bone; the enhanced bone turnover that develops in thyrotoxicosis is characterized by an increase in the number of osteoclasts and resorption sites, and an increase in the ratio of resorptive to formative bone

  5. A model-based cost-effectiveness analysis of osteoporosis screening and treatment strategy for postmenopausal Japanese women.

    Science.gov (United States)

    Yoshimura, M; Moriwaki, K; Noto, S; Takiguchi, T

    2017-02-01

    Although an osteoporosis screening program has been implemented as a health promotion project in Japan, its cost-effectiveness has yet to be elucidated fully. We performed a cost-effectiveness analysis and found that osteoporosis screening and treatment would be cost-effective for Japanese women over 60 years. The purpose of this study was to estimate the cost-effectiveness of osteoporosis screening and drug therapy in the Japanese healthcare system for postmenopausal women with no history of fracture. A patient-level state transition model was developed to predict the outcomes of Japanese women with no previous fracture. Lifetime costs and quality-adjusted life years (QALYs) were estimated for women who receive osteoporosis screening and alendronate therapy for 5 years and those who do not receive the screening and treatments. The incremental cost-effectiveness ratio (ICER) of the screening option compared with the no screening option was estimated. Sensitivity analyses were performed to examine the influence of parameter uncertainty on the base case results. The ICERs of osteoporosis screening and treatments for Japanese women aged 50-54, 55-59, 60-64, 65-69, 70-74, and 75-79 years were estimated to be $89,242, $64,010, $40,596, $27,697, $17,027, and $9771 per QALY gained, respectively. Deterministic sensitivity analyses showed that several parameters such as the disutility due to vertebral fracture had a significant influence on the base case results. Applying a willingness to pay of $50,000 per QALY gained, the probability that the screening option became cost-effectiveness estimated to 50.9, 56.3, 59.1, and 64.7 % for women aged 60-64, 65-69, 70-74, and 75-79 years, respectively. Scenario analyses showed that the ICER for women aged 55-59 years with at least one clinical risk factor was below $50,000 per QALY. In conclusion, dual energy X-ray absorptiometry (DXA) screening and alendronate therapy for osteoporosis would be cost-effective for

  6. Papers of the Canadian Institute conference on buying power in Ontario : critical starting-gate information evolving strategies to reduce costs and minimize risk

    International Nuclear Information System (INIS)

    2002-01-01

    Industry executives and senior government officials attended this conference to learn what to expect when the electricity market opens in Ontario. Topics of discussion included the new risks as well as hedging strategies to manage volatile electricity prices. Papers presented a status update regarding what services to expect from utilities and marketers in a deregulated market. Several presentations described Alberta's experience with deregulation and presented lessons that Ontario can learn to save time, money and how to best deal with electricity contracts. Methods to control and monitor energy consumption and energy costs internally were also described. A total of 14 papers were presented, of which 4 were indexed separately for inclusion in the database. tabs., figs

  7. Cogeneration markets in Ontario

    International Nuclear Information System (INIS)

    Poredos, S.

    1993-01-01

    Cogeneration offers a key strategy which supports global competitiveness for Ontario businesses, encourages energy efficiency and environmental protection, and offers natural gas utilities and producers stable long-term incremental markets. By supporting cogeneration projects, electric utilities will benefit from increased flexibility. Natural gas is the fuel of choice for cogeneration, which can in most cases be easily integrated into existing operations. In Ontario, electric demand grew along with the gross domestic product until 1990, but has decreased with the recent economic recession. The provincial utility Ontario Hydro is resizing itself to stabilize total rate increases of 30% over the last three years and supporting reduction of its high debt load. Rate increases are supposed to be limited but this may be difficult to achieve without further cost-cutting measures. Cogeneration opportunities exist with many institutional and industrial customers who are trying to remain globally competitive by cutting operating costs. In general, cogeneration can save 20% or more of total annual energy costs. Due to excess capacity, Ontario Hydro is not willing to purchase electric power, thus only electric load displacement projects are valid at this time. This will reduce overall savings due to economies of scale. In southwestern Ontario, Union Gas Ltd. has been successful in developing 40 MW of electric displacement projects, providing a total load of 5 billion ft 3 of natural gas (50% of which is incremental). Over 3,000 MW of technical cogeneration potential is estimated to exist in the Union Gas franchise area

  8. Ontario's energy action plan

    International Nuclear Information System (INIS)

    2003-07-01

    In the fall of 2002, the government of Ontario announced an action plan designed to ensure stable electricity prices while additional electricity generating capacity is built. The action plan included a strategy for encouraging major private sector investments in wind, solar and other renewable energy sources. The strategies for new renewable energy projects include: property tax incentives, business income tax incentives, and sales tax rebates. Initiatives to increase supply include: Toronto's Portland 550 megawatt, natural gas-fired generating station, Niagara Falls' Beck Tunnel Project, and Windsor's 580 megawatt natural gas-fired generating station. The government is promoting energy conservation by reducing its electricity consumption by 10 per cent, and setting a target where 20 per cent of electricity consumed in the province must be from renewable energy sources. The use of interval meters by Ontario residents is being encouraged. A provincial sales tax rebate is being offered to customers buying select energy efficient appliances. In its commitment to environmental protection, the Ontario government is phasing out coal, offering rebates for solar energy systems, implementing measures to reduce acid rain, and investing $3.25 billion over ten years to renew and expand public transit. In Chatham, Ontario, a plant producing ethanol from corn was built, and others are planned for other parts of the province. Tax incentives are also offered for alternative fuel users. 1 ref., 1 tab

  9. Osteoporosis: primary prevention in the community.

    Science.gov (United States)

    Loh, K Y; Shong, H K

    2007-10-01

    The incidence of osteoporosis is increasing worldwide. It has great impact on the life of the elderly population. The most significant medical consequence of osteoporosis is fragility fracture which without proper treatment will cause severe medical and psychosocial complications. The overall cost in managing osteoporosis and its related fractures is escalating. Using bone densitometry to measure bone mineral density is useful in the diagnosis of osteoporosis but it is costly and not feasible in the community. Drugs such as estrogen replacement, raloxifene and calcitonin are effective in prevention and treatment of osteoporosis but they are also expensive. Identifying modifiable risk factors such as smoking, lack of exercise, low dietary calcium and vitamin D intake and healthy life style remain strategy in the primary prevention of osteoporosis in the community.

  10. Osteoporose Osteoporosis

    Directory of Open Access Journals (Sweden)

    Julio Cesar Gali

    2001-06-01

    Full Text Available A osteoporose é uma doença ósteo-metabólica que atinge especialmente mulheres após a menopausa. Segundo a Organização Mundial de Saúde 1/3 das mulheres brancas acima dos 65 anos são portadoras de osteoporose. Entretanto estima-se que um homem branco de 60 anos tenha 25 % de chance de ter uma fratura osteoporótica. O diagnóstico e planejamento terapêutico são baseados na densitometria óssea e na dosagem laboratorial dos marcadores de formação e reabsorção óssea. A densitometria também é o melhor preditor de fraturas. Os medicamentos atualmente disponíveis atuam mais na inibição da reabsorção óssea. A principal forma de tratamento da osteoporose é a prevenção: deve-se evitar o fumo; álcool e café devem ser consumidos com moderação; a atividade física e ingestão adequada de cálcio são fundamentais; o treinamento proprioceptivo pode colaborar para prevenir quedas e, conseqüentemente, as fraturas.Osteoporosis is an osteometabolic disease affecting mainly postmenopausal women. According to the World Health Organization, 1/3 of older than 65 white women are affected by osteoporosis. Notwithstanding, the estimates say that 60-year old white males have a 25% chance of osteoporotic fractures. Diagnosis and the therapeutic design are based on bone densitometry and laboratory determinations of formation and bone reabsorption markers. Densitometry is the best fracture predictor. Currently available drugs act inhibiting bone reabsorption. The main form of treatment of osteoporosis is prevention: smoking must be avoided; alcohol and coffee drinking must be moderate; physical activity and adequate calcium intake are fundamental; proprioceptive training can prevent falls and, consequently, fractures.

  11. The Ontario Food and Nutrition Strategy: identifying indicators of food access and food literacy for early monitoring of the food environment

    Directory of Open Access Journals (Sweden)

    Beatrice A. Boucher

    2017-09-01

    Full Text Available Introduction: To address challenges Canadians face within their food environments, a comprehensive, multistakeholder, intergovernmental approach to policy development is essential. Food environment indicators are needed to assess population status and change. The Ontario Food and Nutrition Strategy (OFNS integrates the food, agriculture and nutrition sectors, and aims to improve the health of Ontarians through actions that promote healthy food systems and environments. This report describes the process of identifying indicators for 11 OFNS action areas in two strategic directions (SDs: Healthy Food Access, and Food Literacy and Skills. Methods: The OFNS Indicators Advisory Group used a five-step process to select indicators: (1 potential indicators from national and provincial data sources were identified; (2 indicators were organized by SD, action area and data type; (3 selection criteria were identified, pilot tested and finalized; (4 final criteria were applied to refine the indicator list; and (5 indicators were prioritized after reapplication of selection criteria. Results: Sixty-nine potential indicators were initially identified; however, many were individual-level rather than system-level measures. After final application of the selection criteria, one individual-level indicator and six system-level indicators were prioritized in five action areas; for six of the action areas, no indicators were available. Conclusion: Data limitations suggest that available data may not measure important aspects of the food environment, highlighting the need for action and resources to improve system-level indicators and support monitoring of the food environment and health in Ontario and across Canada.

  12. The Ontario Food and Nutrition Strategy: identifying indicators of food access and food literacy for early monitoring of the food environment.

    Science.gov (United States)

    Boucher, Beatrice A; Manafò, Elizabeth; Boddy, Meaghan R; Roblin, Lynn; Truscott, Rebecca

    2017-09-01

    To address challenges Canadians face within their food environments, a comprehensive, multistakeholder, intergovernmental approach to policy development is essential. Food environment indicators are needed to assess population status and change. The Ontario Food and Nutrition Strategy (OFNS) integrates the food, agriculture and nutrition sectors, and aims to improve the health of Ontarians through actions that promote healthy food systems and environments. This report describes the process of identifying indicators for 11 OFNS action areas in two strategic directions (SDs): Healthy Food Access, and Food Literacy and Skills. The OFNS Indicators Advisory Group used a five-step process to select indicators: (1) potential indicators from national and provincial data sources were identified; (2) indicators were organized by SD, action area and data type; (3) selection criteria were identified, pilot tested and finalized; (4) final criteria were applied to refine the indicator list; and (5) indicators were prioritized after reapplication of selection criteria. Sixty-nine potential indicators were initially identified; however, many were individual-level rather than system-level measures. After final application of the selection criteria, one individual-level indicator and six system-level indicators were prioritized in five action areas; for six of the action areas, no indicators were available. Data limitations suggest that available data may not measure important aspects of the food environment, highlighting the need for action and resources to improve system-level indicators and support monitoring of the food environment and health in Ontario and across Canada.

  13. Success Strategies for Linguistically Competent Healthcare: The Magic Bullets and Cautionary Tales of the Active Offer of French-Language Health Services in Ontario.

    Science.gov (United States)

    Farmanova, Elina; Bouchard, Louise; Bonneville, Luc

    2018-01-01

    An active offer of French-language health services (FLHS) was introduced in several Canadian provinces to help create an environment that will anticipate the needs of Francophones in their community and will stimulate the demand for services in French. For the active offer to be implemented, changes in how health services are organized and managed at both organizational and system levels must be introduced. In this perspective paper, we identify several success strategies and potential pitfalls with regards to the implementation of the active offer of FLHS primarily at the level of healthcare organization. Our recommendations are based on a recent health services research study exploring reorganization and management strategies for the delivery of the active offer of FLHS in Ontario and insights from a focus group with healthcare administrators conducted as part of this research. We propose a ";wrap-around strategy" called organizational health literacy to help reorient organizational culture and improve management and sustainability of the active offer of FLHS. These strategies have relevance for advocates and professionals working to promote an active offer of FLHS, including healthcare administrators, human resource professionals, quality-improvement specialists and others. © 2018 Longwoods Publishing.

  14. Opening Doors to Nursing Degrees: A Proposal from Ontario's Colleges

    Science.gov (United States)

    Colleges Ontario, 2010

    2010-01-01

    Ontario needs to expand nursing education options to improve access to the nursing profession, create better pathways amongst all nursing occupations, and build Ontario's capacity to meet the province's long-term nursing needs. Ontario's colleges are capable of playing a larger role within a long-term provincial strategy for sustaining and…

  15. [Osteoporosis in premenopausal women].

    Science.gov (United States)

    Mitringer, Antje; Pietschmann, P

    2002-01-01

    Osteoporosis is a systemic disease of bone, which is characterized by decreased bone mass and changes in the microarchitecture of bone tissue followed by brittleness of bones and increased risk of fractures. Osteoporosis frequently is a disease of postmenopausal women, nevertheless, in rare cases, osteoporosis can also occur in young adults. There are only few studies on the pathophysiology of "premenopausal osteoporosis"; in addition to idiopathic forms, osteoporosis in young women can be caused by glucocorticoid treatment, by eating disorders or can be associated with pregnancy.

  16. Building osteoporosis prevention into dental practice.

    Science.gov (United States)

    Stewart, Stacey; Hanning, Rhona

    2012-01-01

    The National Report Card on Osteoporosis Care (2008) announced the need for comprehensive approaches to risk reduction and improvement in the early diagnosis of osteoporosis. Dental research has suggested that low systemic bone-mineral density also occurs in alveolar bone, and people with osteoporosis may have an increased risk of tooth loss. Whether or not a causal link exists, both conditions share similar modifiable risk factors, including a role for calcium and vitamin D. The purpose of this paper was to critically examine the role calcium and vitamin D play in the relationship between osteoporosis and the risk of tooth loss. Scientific articles were obtained through PubMed, MEDLINE, CINAHL, AgeLine and Web of Science. Publications were restricted to those involving human subjects, and English-language articles on calcium and vitamin D. The search yielded 8 articles relating to osteoporosis and tooth loss that included calcium and vitamin D intake. Despite methodological concerns, the evidence shows a relationship between osteoporosis and tooth loss for people who have an inadequate intake of calcium and vitamin D. Adequate calcium intake positively influences optimal peak bone mass and may also assist in tooth retention in later life. The dental sector can assist with national prevention strategies for osteoporosis care.

  17. Radiology of osteoporosis

    International Nuclear Information System (INIS)

    Grampp, S.

    2008-01-01

    This second edition of Radiology of Osteoporosis has been fully updated so as to represent the current state of the art. It provides a comprehensive overview of osteoporosis, the pathologic conditions that give rise to osteoporosis, and the complications that are frequently encountered. After initial chapters devoted to pathophysiology, the presentation of osteoporosis on conventional radiographs is illustrated and discussed. Thereafter, detailed consideration is given to each of the measurement methods employed to evaluate osteoporosis, including dual x-ray absorptiometry, vertebral morphometry, spinal and peripheral quantitative computed tomography, quantitative ultrasound, and magnetic resonance imaging. The role of densitometry in daily clinical practice is appraised. Finally, a collection of difficult cases involving pitfalls is presented, with guidance to their solution. The information contained in this volume will be invaluable to all with an interest in osteoporosis. (orig.)

  18. Life Expectancy in Patients Treated for Osteoporosis

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Osmond, Clive; Cooper, Cyrus

    2015-01-01

    Osteoporosis is a chronic disease, carrying an elevated risk of fractures, morbidity, and death. Long-term treatment may be required, but the long-term risks with osteoporosis drugs remain incompletely understood. The competing risk of death may be a barrier to treating the oldest, yet this may...... not be rational if the risk of death is reduced by treatment. It is difficult to devise goal-directed long-term strategies for managing osteoporosis without firm information about residual life expectancy in treated patients. We conducted an observational study in Danish national registries tracking prescriptions...... for osteoporosis drugs, comorbid conditions, and deaths. We included 58,637 patients and 225,084 age- and sex-matched control subjects. Information on deaths until the end of 2013 was retrieved, providing a follow-up period of 10 to 17 years. In men younger than 80 years and women younger than 60 years...

  19. Ontario demand response scenarios

    International Nuclear Information System (INIS)

    Rowlands, I.H.

    2005-09-01

    Strategies for demand management in Ontario were examined via 2 scenarios for a commercial/institutional building with a normal summertime peak load of 300 kW between 14:00 and 18:00 during a period of high electricity demand and high electricity prices. The first scenario involved the deployment of a 150 kW on-site generator fuelled by either diesel or natural gas. The second scenario involved curtailing load by 60 kW during the same periods. Costs and benefits of both scenarios were evaluated for 3 groups: consumers, system operators and society. Benefits included electricity cost savings, deferred transmission capacity development, lower system prices for electricity, as well as environmental changes, economic development, and a greater sense of corporate social responsibility. It was noted that while significant benefits were observed for all 3 groups, they were not substantial enough to encourage action, as the savings arising from deferred generation capacity development do not accrue to individual players. The largest potential benefit was identified as lower prices, spread across all users of electricity in Ontario. It was recommended that representative bodies cooperate so that the system-wide benefits can be reaped. It was noted that if 10 municipal utilities were able to have 250 commercial or institutional customers engaged in distributed response, then a total peak demand reduction of 375 MW could be achieved, representing more than 25 per cent of Ontario's target for energy conservation. It was concluded that demand response often involves the investment of capital and new on-site procedures, which may affect reactions to various incentives. 78 refs., 10 tabs., 5 figs

  20. [Secondary osteoporosis in gynecology].

    Science.gov (United States)

    Taguchi, Y; Gorai, I

    1998-06-01

    Several diseases and medications are known to induce secondary osteoporosis. Among them, same situations are related to gynecological field. They include Turner's syndrome, anorexia nervosa, ovarian dysfunction, oophorectomy, GnRH agonist therapy, and osteoporosis associated with pregnancy. We briefly describe these secondary osteoporosis in this article as follows. Several studies have found osteoporosis to be a common complication of Turner's syndrome and hormone replacement therapy has been used as a possible management; in anorexic patient, low body weight, prolonged amenorrhea, early onset of anorexia nervosa, and hypercortisolism have been reported to be risks for bone demineralization; since oophorectomy which is a common intervention in gynecology leads osteoporosis, it is important to prevent osteoporosis caused by surgery as well as postmenopausal osteoporosis; GnRH agonist, which induces estrogen deficient state and affect bone mass, is commonly used as a management for endometriosis and leiomyoma of uterus; associated with pregnancy, post-pregnancy spinal osteoporosis and transient osteoporosis of the hip are clinically considered to be important and heparin therapy and magnesium sulfate therapy are commonly employed during pregnancy, affecting calcium homeostasis.

  1. Ontario Hydro's nuclear program

    International Nuclear Information System (INIS)

    McCredie, J.

    1984-01-01

    This report briefly describes Ontario Hydro's nuclear program, examining the design and construction status, and the future from Ontario Hydro's perspective. Ontario Hydro relies heavily on nuclear power. Nuclear fuel was responsible for approximately 34% of Ontario Hydro's energy production in 1983. The nuclear proportion was supplied by twelve operating units located: NPD, Douglas Point, Pickering A and B. It is expected that by approximately 1992, 65% of the total energy needs will be generated through nuclear power

  2. Osteoporosis and diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Andrea Montagnani

    2013-03-01

    Full Text Available Introduction: Diabetes mellitus (DM and osteoporotic fractures are major causes of mortality and morbidity in older subjects. Recent reports have revealed close association between fracture risk and DM types 1 and 2 (DM1 and DM2, respectively. Aim of this review is to highlight the importance of these diseases in the elderly and examine certain etiopathogenetic aspects of DM associated osteoporosis, which could be useful in management of diabetic patients. Materials and methods: We searched the Embase and PubMed databases using diabetes, osteoporosis, and bone mineral density (BMD as search terms and 1989-2009 as publication dates. Discussion: The risk of fractures seems to be increased in both types of DM although DM2 seems to be associated with normal-high BMDs compared with the normal population. This apparent paradox could reflect greater bone frailty in diabetic patients that are unrelated to adipose tissue, hyperinsulinemia, deposition of advanced glycosylation end products in collagen, reduced serum IGF-1 levels, hypercalciuria, renal failure, microangiopathy, and/or inflammation. Diabetic patients’ propensity to fall and multiple comorbidities might also explain their higher fracture rates. The effects of drugs that inhibit bone resorption in diabetic patients are probably similar to those obtained in nondiabetics although there is little information on this issue. In general, effective treatment of diabetes has positive effects on bone metabolism. Metformin acts directly on bone tissue, reducing AGE accumulation, and insulin has direct effects on osteoclast activity. In contrast, the thiazolidinediones seem to have negative effects since they orient mesenchymal progenitor cell differentiation toward adipose rather than bone tissue. Incretin therapy is a newer approach that appears to modify interactions between nutrition and bone turnover (e.g., postprandial suppression of bone resorption. Conclusions: Better understanding of how

  3. Meeting Ontario's electricity needs : a critical review of the Ontario Power Authority's supply mix advice report

    International Nuclear Information System (INIS)

    Gibbons, J.; Fracassi, J.

    2006-01-01

    In December, 2005 the Ontario Power Authority (OPA) outlined its proposed blueprint for meeting Ontario's electricity needs to 2025 in the document entitled Supply Mix Advice Report. As a result of the actions taken by the current government, the OPA believes that Ontario will have adequate electricity supplies to meet the province's needs until 2013. However, it stated that Ontario will require an additional 15,000 megawatts of new generation capacity between 2013 and 2025. The OPA also recommends that a significant proportion of this new generation capacity be nuclear. The Ontario Clean Air Alliance undertook a review of the OPA report and identified several discrepancies including an over-estimation of Ontario's rate of electricity load growth from 2005 to 2025; an under-estimation of the potential for electricity productivity improvements to reduce electricity demand and raise living standards; an under-estimation of renewable energy supply potential; an under-estimation of the potential for biomass and natural gas fired combined heat and power plants to meet electricity needs and increase the competitiveness of Ontario's industries; an under-estimation of the economic costs and risks of nuclear power; and a biased recommendation for a 70 million dollar resource acquisition budget against energy efficiency investments that would reduce demand and raise living standards. This report provides the Ontario Clean Air Alliances' analysis of the OPA report and presents it own recommendations for how Ontario can increase its electricity productivity and meet its electricity supply needs until 2025. The report concluded that the Government of Ontario should direct the OPA to develop a long-term strategy to raise the price of electricity up to its full cost without raising the electricity bills of low income consumers or impairing the competitiveness of Ontario's industries. It was suggested that Ontario's electricity productivity should be increased to the same level as

  4. Physiotherapy interventions in osteoporosis

    NARCIS (Netherlands)

    Swanenburg, J; Mulder, T; de Bruin, ED; Uebelhart, D

    2003-01-01

    Osteoporosis is an increasing public health problem which ultimately causes fractures and a significant reduction in patient's health-related quality of life. In this context, physiotherapists are involved in a wide range of therapies related both to prevention and treatment of osteoporosis. The

  5. X-ray safety in Ontario

    International Nuclear Information System (INIS)

    1980-03-01

    In July 1979 the Ontario Advisory Committee on Radiology was formed to develop a comprehensive strategy for x-ray safety in the province. At its hearings the committee recieved submissions from groups representing physicians, dentists, chiropractors, radiological technicians, physiotherapists, podiatrists, and consumers, among others; these briefs are included as appendices to the report. The report surveys the historical background and the current situation in Ontario, and makes recommendations for an organized safety program. (L.L.)

  6. Transient regional osteoporosis

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-09-01

    Full Text Available Transient osteoporosis of the hip and regional migratory osteoporosis are uncommon and probably underdiagnosed bone diseases characterized by pain and functional limitation mainly affecting weight-bearing joints of the lower limbs. These conditions are usually self-limiting and symptoms tend to abate within a few months without sequelae. Routine laboratory investigations are unremarkable. Middle aged men and women during the last months of pregnancy or in the immediate post-partum period are principally affected. Osteopenia with preservation of articular space and transitory edema of the bone marrow provided by magnetic resonance imaging are common to these two conditions, so they are also known by the term regional transitory osteoporosis. The appearance of bone marrow edema is not specific to regional transitory osteoporosis but can be observed in several diseases, i.e. trauma, reflex sympathetic dystrophy, avascular osteonecrosis, infections, tumors from which it must be differentiated. The etiology of this condition is unknown. Pathogenesis is still debated in particular the relationship with reflex sympathetic dystrophy, with which regional transitory osteoporosis is often identified. The purpose of the present review is to remark on the relationship between transient osteoporosis of the hip and regional migratory osteoporosis with particular attention to the bone marrow edema pattern and relative differential diagnosis.

  7. Osteoporosis and trace elements

    DEFF Research Database (Denmark)

    Aaseth, J.; Boivin, G.; Andersen, Ole

    2012-01-01

    More than 200 million people are affected by osteoporosis worldwide, as estimated by 2 million annual hip fractures and other debilitating bone fractures (vertebrae compression and Colles' fractures). Osteoporosis is a multi-factorial disease with potential contributions from genetic, endocrine...... in new bone and results in a net gain in bone mass, but may be associated with a tissue of poor quality. Aluminum induces impairment of bone formation. Gallium and cadmium suppresses bone turnover. However, exact involvements of the trace elements in osteoporosis have not yet been fully clarified...

  8. Radiological diagnosis of osteoporosis

    International Nuclear Information System (INIS)

    Heuck, F.H.W.

    1990-01-01

    The roentgen-morphologic findings of 'osteoporosis' in the different regions of the skeleton are demonstrated. A combination of osteoporosis and osteomalacia induced by hormonal and metabolic bone diseases occur frequently. The results of sequential studies are discussed. Diagnostic informations obtained by quantitative radiology, especially by different methods like x-ray morphometry, densitometry with gamma-rays of isotopes of different energies, quantitative computed tomography, and imaging analysis with electronic methods are described. The sequential use of diagnostic imaging techniques in cases of suspected osteoporosis are explained. (Author)

  9. Ontario Hydro's DSP update

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    Ontario Hydro's Demand/Supply Plan (DSP), the 25 year plan which was submitted in December 1989, is currently being reviewed by the Environmental Assessment Board (EAB). Since 1989 there have been several changes which have led Ontario Hydro to update the original Demand/Supply Plan. This information sheet gives a quick overview of what has changed and how Ontario Hydro is adapting to that change

  10. Hyponatremia and osteoporosis

    DEFF Research Database (Denmark)

    Kruse, Christian; Eiken, P; Vestergaard, P

    2015-01-01

    UNLABELLED: The association between hyponatremia and osteoporosis was evaluated in humans. A significant association was found between low sodium levels, lower bone mineralization in the hip, and with several common conditions. Hyponatremia could be used as a marker of osteoporosis and systemic...... disease. INTRODUCTION: The objective of this study was to evaluate the association between hyponatremia and osteoporosis in humans through a cross-sectional study. METHODS: Patient information was gathered from regional and national Danish patient databases, both in- and outpatient settings, from 2004...... and lumbar spine bone mineral content (BMC) and densities (BMD) and T-scores were all significantly lower with hyponatremia. The odds ratio (OR) of osteoporosis significantly increased among hyponatremic patients at both total hip (unadjusted OR = 2.17, 95% CI = [1.40-3.34], p

  11. Life with osteoporosis

    DEFF Research Database (Denmark)

    Hansen, Carrinna

    Background: Osteoporosis is considered a major worldwide public health problem. Men and women with osteoporosis are mostly unaware of the illness, until bone fractures occur. It is estimated that more than one in three European women and one in five men over 50 years will experience osteoporotic...... fractures followed by considerable morbidity and mortality. In line with many other chronic illnesses, one of the pronounced challenges related to osteoporosis is considered to be compliance and persistence to medical treatment. The causes of low compliance and persistence to treatment remain unclear....... Living with a chronic illness often affects the entire human life situation, specifically, emotionally and existentially. How this is experienced personally and how this affects the individual’s life is still unknown. Aim: To gain a deeper understanding of patients’ life with osteoporosis by determining...

  12. Osteoporosis in premenopausal women.

    Science.gov (United States)

    Langdahl, Bente L

    2017-07-01

    The scope of this review was to review the newest developments in the context of the existing knowledge on premenopausal bone fragility. Fragility fractures are common in postmenopausal women and men and diagnostic criteria for osteoporosis have been agreed and multiple pharmacological treatments have been developed over the last 25 years. In premenopausal women, fragility fractures and very low bone mass are uncommon and osteoporosis in premenopausal women has therefore attracted much less interest. Recent studies have highlighted that lifestyle and dietary habits affect premenopausal bone mass. Bone mass may be improved by sufficient intake of calcium and vitamin D together with increased physical activity in premenopausal women with idiopathic osteoporosis. If pharmacological treatment is needed, teriparatide has been demonstrated to efficiently increase bone mass; however, no fracture studies and no comparative studies against antiresorptive therapies have been conducted. Pregnancy affects bone turnover and mass significantly, but pregnancy-associated osteoporosis is a rare and heterogeneous condition. The diagnosis of osteoporosis should only be considered in premenopausal women with existing fragility fractures, diseases or treatments known to cause bone loss or fractures. Secondary causes of osteoporosis should be corrected or treated if possible. The women should be recommended sufficient intake of calcium and vitamin and physical activity. In women with recurrent fractures or secondary causes that cannot be eliminated, for example glucocorticoid or cancer treatment, pharmacological intervention with bisphosphonates or teriparatide (not in the case of cancer) may be considered.

  13. Awareness and Perceptions of Published Osteoporosis Clinical ...

    African Journals Online (AJOL)

    Awareness and Perceptions of Published Osteoporosis Clinical Guidelines-a Survey of Primary Care Practitioners in the Cape Town Metropolitan Area. ... Further attention needs to be focused on developing implementation and dissemination strategies of evidence-based guidelines in South Africa. South African Journal of ...

  14. Ontario electricity industry restructuring

    International Nuclear Information System (INIS)

    1999-01-01

    The objective of Ontario's electricity industry restructuring was described as an effort to enhance Ontario's competitiveness. It is believed that restructuring can be accomplished without an increase in electricity rates. In a series of charts, the report provides the timeline of restructuring from the time of the Macdonald report in 1995 to the beginning of open competition in Ontario electricity markets. It oulines the principles underlying the financial restructuring and the financial results of restructuring, including the size of the stranded debt ($ 7.8 billion). It lists the changes that have occurred since October 1998, explains some key factors in valuing the successor companies and profiles the Ontario Electricity Financial Corporation. Restructuring of the industry is expected to have a neutral to positive impact on Ontario's fiscal position. The residual stranded debt of $7.8 billion will be retired through revenues generated by the electricity sector, without recourse to the Provincial Treasury. 9 figs

  15. Market surveillance in Ontario

    International Nuclear Information System (INIS)

    Chandler, H.

    2002-01-01

    On May 1, 2002 both wholesale and retail electricity markets in Ontario were opened to competition. Wholesale electricity market sales of 150 TWh were valued at over $11 billion with 27,500 MW in service installed capacity and 4,000 to 6,000 MW import/export capability with strong interconnections to the Quebec, the Midwest and the Northeast. The key players in Ontario's electricity market are the Ontario Energy Board (OEB), the Independent Electricity Market Operator (IMO), Ontario Power Generation, and Hydro One. The OEB regulatory framework includes licensing and front line, daily monitoring of whole sale market. Serious capacity problems in Ontario have manifested themselves in tight supply and demand situations and highly volatile prices. The paper included graphs of available reserves for 1996 to 2002, HOEP trends and frequency, HOEP comparison, and a sensitivity to demand forecast. 1 tab., 6 figs

  16. Ontario energy review

    International Nuclear Information System (INIS)

    1990-03-01

    This publication provides a review of the developments in Ontario in relation to the national and international energy scene. Ontario is the largest energy consumer in Canada and is highly dependent on external energy sources. Several developments have significantly altered the Ontario energy scene. Oil and gas markets have become deregulated and market forces increasingly determine prices. A free trade agreement with the United States makes Ontario even more affected by international markets. Oil and gas prices have fallen from the high levels of the 1980s, but energy efficiency and conservation continue to be extremely important because they affect economic performance and the environment. In the next few years the greatest challenges will be to continue improving energy efficiency, to reduce the impact of energy on the environment, and to ensure the availability of sufficient energy supplies for future needs. This review contains statistics on energy in Ontario and explains them for the non-specialist. (7 tabs., figs.)

  17. Sparking investment in Ontario's power generation industry

    International Nuclear Information System (INIS)

    Allen, J.

    2004-01-01

    This paper discusses the business strategy needed to spark investment in Ontario's power generation industry. It examines the process of decision making and investing in an uncertain environment. The paper suggests that any strategy based on one view of the future courts trouble and that strategic flexibility can prepare for what cannot be predicted. Finally the paper suggests that Ontario needs to create a stable policy and regulatory environment that allows investors to fulfill reasonable expectations and investors need to place bets that provide the flexibility to respond quickly to changing market conditions

  18. [Osteoporosis and stress].

    Science.gov (United States)

    Kumano, Hiroaki

    2005-09-01

    There may be three ways of relationship between stress and osteoporosis. The first is that stress induces some physiological changes leading to osteoporosis. The second is that stress induces behavioral distortion of eating, drinking, exercise, and sleep habits, which leads to osteoporosis. The third is that osteoporosis, on the other hand, brings about anxiety, depression, loss of social roles, and social isolation, which leads to stress. The susceptible sex and age groups are postmenopausal women and young women. The abrupt decrease of estrogen in postmenopausal women promotes reabsorption of bone, and it was also reported that the increase of interleukin-6 (IL-6) that is downstream of estrogen was related to the production of osteoclast and to the development of disability of the aged. Regarding the association with stress, while it was reported that depression or depressive states directly increased inflammation-induced cytokines including IL-6, it was also pointed out that stress-induced easy infectious may produce chronic infection, which indirectly increases inflammation-induced cytokines. Anorexia Nervosa that is assumed to be associated with adolescent developmental stress is noteworthy in young women. Amenorrhea is always present in this disease, and in addition to bone reabsorption associated with estrogen deficiency, the decrease of bone formation associated with malnutrition may be related to the development of osteoporosis.

  19. Diabetes Mellitus and Osteoporosis

    Directory of Open Access Journals (Sweden)

    Dilek Durmuş

    2005-09-01

    Full Text Available Osteoporosis is a condition of bone fragility resulting from micro-architectural deterioration and decreased bone mass. Studies on the presence of a generalized osteoporosis related to diabetes mellitus (DM are few and controversial. Factors associated with osteoporosis diabetes in which may account for the patogenesis of diabetic bone loss have been studied. This article will review the relevant litarature relating to diabetes and osteoporosis including cellular and animal models. These studies include vascular and neuropathic mechanism, poor glisemic control, abnormalities of calcium and vitamin D metabolism and hypercalciuria with secondary increase in parathyroid hormone secretion, the role of insülin and insülin like growth factor I. It appears that there is a great deal of variability in the bone mineral density and fracture rates in both type I and type II DM. This may reflect multiple factors such as the population, age, duration of diabetes and insülin use. There is need for further longitudinal studies, including the incidence and risk factors for osteoporosis in DM.

  20. [Epidemiology of osteoporosis].

    Science.gov (United States)

    Grazio, Simeon

    2006-01-01

    Osteoporosis represents a major and increasing public health problem with the aging of population. Major clinical consequences and economic burden of the disease are fractures. Many risk factors are associated with the fractures including low bone mass, hormonal disorders, personal and family history of fractures, low body weight, use of certain drugs (e.g. glucocorticoids), cigarette smoking, elevated intake of alchohol, low physical activity, insufficient level of vitamin D and low intake of calcium. This epidemiological review describes frequency, importance of risk factors and impact of osteoporosis and osteoporotic fractures. Objective measures of bone mineral density along with clinical assessment of risk factors can help identify patients who will benefit from prevention and intervention efforts and eventually reduce the morbidity and mortality associated with osteoporosis-related fractures.

  1. Osteoporosis and prostate cancer

    DEFF Research Database (Denmark)

    Poulsen, Mads Hvid; Nielsen, Morten Frost Munk; Abrahamsen, Bo

    2014-01-01

    Abstract Objective. The aim of this study was to analyse the prevalence of osteoporosis and risk factors of osteoporotic fractures before androgen deprivation in Danish men. Treatment and prognosis of prostate cancer necessitate management of long-term consequences of androgen deprivation therapy...... (ADT), including accelerated bone loss resulting in osteoporosis. Osteoporotic fractures are associated with excess morbidity and mortality. Material and methods. Patients with prostate cancer awaiting initiation of ADT were consecutively included. Half of the patients had localized disease and were...... level was 30.5 g/l (1-5714 g/l). The average Gleason score was 7.8 (range 5-10, SD 1.1). Fifty patients had localized prostate cancer and the other 55 patients had disseminated disease. The prevalence of osteoporosis was 10% and the prevalence of osteopenia was 58% before ADT. There was no significant...

  2. Osteoporosis in men

    Directory of Open Access Journals (Sweden)

    Waldemar Misiorowski

    2017-06-01

    Full Text Available Osteoporotic fractures are the leading cause of morbidity and mortality among aging men. 30% of all hip fractures occur in men, and mortality resulting from not only the hip fracture, but also the spine and other major osteoporotic fractures, is significantly higher in men than in women. As in women, hypogonadism is the best documented risk factor for developing osteoporosis in men. In older men, testosterone levels are negatively correlated with the risk of fractures, and it seems that this age-related testosterone deficiency should not be considered as one of the many causes of secondary osteoporosis, rather one of the major and most important mechanisms of senile osteoporosis. Acute hypogonadism induced by ablation treatment for prostate cancer (surgical or pharmacological castration, antiandrogen therapy is associated with an extremely high risk of fracture. Other documented causes of bone loss in men are cigarette smoking and alcohol abuse, and a number of diseases that require corticosteroid treatment. Pharmacotherapy of osteoporosis should be recommended to all men with a diagnosed osteoporotic fracture and all men with a high 10-year absolute fracture risk (FRAXTM. Not all drugs registered for the treatment of postmenopausal osteoporosis have been registered for the treatment of osteoporosis in men, and others have not been the subject of long-term and costly clinical trials required for such registration. The risk reduction of new fractures was documented only for treatment with zoledronic acid. Risedronate, strontium ranelate, teriparatide, and denosumab in men increase in bone mineral density comparable to that seen in postmenopausal women.

  3. Osteoporosis Treatment: Medications Can Help

    Science.gov (United States)

    ... help Osteoporosis treatment may involve medication along with lifestyle change. Get answers to some of the most common ... 2017. Khan M, et al. Drug-related adverse events of osteoporosis therapy. ... and management of osteoporosis. European Journal of Rheumatology. 2017;4: ...

  4. Management of osteoporosis in rheumatoid arthritis patients.

    Science.gov (United States)

    Hoes, Jos N; Bultink, Irene E M; Lems, Willem F

    2015-03-01

    In rheumatoid arthritis (RA) patients, the risk of both vertebral and non-vertebral fractures is roughly doubled, which is for an important part caused by inflammation-mediated amplification of bone loss and by immobilization. New treatments have become available in the last two decades to treat both RA and osteoporosis. Epidemiology and assessment of osteoporosis and fracture risk (including the influence of RA disease activity and bone-influencing medications such as glucocorticoids), the importance of vertebral fracture assessment in addition to bone density measurement in patients with RA, the use of disease-modifying antirheumatic drugs and their effects on generalized bone loss, and current and possible future anti-osteoporotic pharmacotherapeutic options are discussed with special focus on RA. Assessment of osteoporosis in RA patients should include evaluation of the effects of disease activity and bone-influencing medications such as (the dose of) glucocorticoids, above standard risk factors for fractures or osteoporosis as defined by the FRAX instrument. Disease-modifying antirheumatic drugs are now well able to control disease activity using treat to target strategies. This lowering of disease activity by antirheumatic medications such as anti-TNF-α results in hampering of generalized bone loss; however, no fracture data are currently available. When treating osteoporosis in RA patients, additional focus should be on calcium supplementation, particularly in glucocorticoid users, and also on sufficient vitamin D use. Several anti-osteoporotic medications are now on the market; oral bisphosphonates are most commonly used, but in recent years, more agents have entered the market such as the parenteral antiresorptives denosumab (twice yearly) and zoledronic acid (once yearly), and the anabolic agent parathyroid hormone analogues. New agents, such as odanacatib and monoclonal antibodies against sclerostin, are now being tested and will most likely enlarge the

  5. Bathymetry of Lake Ontario

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Bathymetry of Lake Ontario has been compiled as a component of a NOAA project to rescue Great Lakes lake floor geological and geophysical data and make it more...

  6. Antidepressant medications and osteoporosis

    DEFF Research Database (Denmark)

    Rizzoli, R; Cooper, C; Reginster, J-Y

    2012-01-01

    Use of antidepressant medications that act on the serotonin system has been linked to detrimental impacts on bone mineral density (BMD), and to osteoporosis. This article reviews current evidence for such effects, and identifies themes for future research. Serotonin receptors are found in all major...

  7. Genetics of osteoporosis

    Energy Technology Data Exchange (ETDEWEB)

    Urano, Tomohiko [Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655 (Japan); Inoue, Satoshi, E-mail: INOUE-GER@h.u-tokyo.ac.jp [Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655 (Japan); Department of Anti-Aging Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655 (Japan); Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Saitama (Japan)

    2014-09-19

    Highlights: • Single-nucleotide polymorphisms (SNPs) associated with osteoporosis were identified. • SNPs mapped close to or within VDR and ESR1 are associated with bone mineral density. • WNT signaling pathway plays a pivotal role in regulating bone mineral density. • Genetic studies will be useful for identification of new therapeutic targets. - Abstract: Osteoporosis is a skeletal disease characterized by low bone mineral density (BMD) and microarchitectural deterioration of bone tissue, which increases susceptibility to fractures. BMD is a complex quantitative trait with normal distribution and seems to be genetically controlled (in 50–90% of the cases), according to studies on twins and families. Over the last 20 years, candidate gene approach and genome-wide association studies (GWAS) have identified single-nucleotide polymorphisms (SNPs) that are associated with low BMD, osteoporosis, and osteoporotic fractures. These SNPs have been mapped close to or within genes including those encoding nuclear receptors and WNT-β-catenin signaling proteins. Understanding the genetics of osteoporosis will help identify novel candidates for diagnostic and therapeutic targets.

  8. Management of osteoporosis

    Directory of Open Access Journals (Sweden)

    Lewiecki E Michael

    2004-07-01

    Full Text Available Abstract Osteoporosis or osteopenia occurs in about 44 million Americans, resulting in 1.5 million fragility fractures per year. The consequences of these fractures include pain, disability, depression, loss of independence, and increased mortality. The burden to the healthcare system, in terms of cost and resources, is tremendous, with an estimated direct annual USA healthcare expenditure of about $17 billion. With longer life expectancy and the aging of the baby-boomer generation, the number of men and women with osteoporosis or low bone density is expected to rise to over 61 million by 2020. Osteoporosis is a silent disease that causes no symptoms until a fracture occurs. Any fragility fracture greatly increases the risk of future fractures. Most patients with osteoporosis are not being diagnosed or treated. Even those with previous fractures, who are at extremely high risk of future fractures, are often not being treated. It is preferable to diagnose osteoporosis by bone density testing of high risk individuals before the first fracture occurs. If osteoporosis or low bone density is identified, evaluation for contributing factors should be considered. Patients on long-term glucocorticoid therapy are at especially high risk for developing osteoporosis, and may sustain fractures at a lower bone density than those not taking glucocorticoids. All patients should be counseled on the importance of regular weight-bearing exercise and adequate daily intake of calcium and vitamin D. Exposure to medications that cause drowsiness or hypotension should be minimized. Non-pharmacologic therapy to reduce the non-skeletal risk factors for fracture should be considered. These include fall prevention through balance training and muscle strengthening, removal of fall hazards at home, and wearing hip protectors if the risk of falling remains high. Pharmacologic therapy can stabilize or increase bone density in most patients, and reduce fracture risk by about 50

  9. [Daily practice using the guidelines for prevention and treatment of osteoporosis. Effectiveness of exercise for preventing and treating osteoporosis].

    Science.gov (United States)

    Miyakoshi, Naohisa

    2008-08-01

    There is increasing evidence that exercise is an effective strategy for the prevention and treatment of osteoporosis. The randomized controlled trials and their meta-analyses to date, evaluating the effects of exercise on osteoporosis reveal that the exercise is effective in preserving bone mass, preventing fractures and falls, and improving quality of life in patients with osteoporosis. Emphasis is also given to the importance of the specific protocols of exercises needed to achieve positive effects safely, keeping in view the age and general physical condition of the person.

  10. Restructuring in Ontario : electricity sector reform

    International Nuclear Information System (INIS)

    Pospisil, S.

    2004-01-01

    Ontario's electricity reform strategy was outlined along with challenge facing Ontario's electricity supply and demand with particular focus on the issue of replacing coal-fired generation. According to reports by the Independent Electricity Market Operator, short-term reserve margins were higher in 2004 than they were in 2003 due to the return to service of some nuclear generating units and planned capacity additions. Ontario's long-term supply and demand situation was also examined. It was noted that lenders hesitate to finance the expansion of generation companies selling into the spot market. Many lenders are requiring that half of the project's output be sold in advance on contract. Other challenges include Ontario's aging generation infrastructure and rising energy prices. The presentation included graphs that compared electricity costs for residential and small business customers across various provinces and states. The main supply and conservation challenges revolve around the large investments required by 2020 to replace coal plants, retire nuclear plants and projected load growth. Ontario's current generation capacity is 154 TWh and the mix is represented by 40 per cent nuclear, 25 per cent coal, 25 per cent hydro, 8 per cent natural gas, 1 per cent oil, and 1 per cent biomass and other renewable energy sources. This paper also addressed the issue of coal generation and air pollution and emphasized the importance of looking at the broad externalities associated with air emissions. tabs., figs

  11. Hemofilia y osteoporosis

    Directory of Open Access Journals (Sweden)

    Carlos Andrés Pérez Martínez

    2008-12-01

    Full Text Available Una relación entre la hemofilia y la osteoporosis ha sido sugerida, lo cual ha conducido a la iniciativa de realizar tanto revisiones como estudios acerca de este tema. Las hemofilias son un trastorno de la coagulación hereditario, causado por deficiencia o defecto en la actividad coagulante de los factores VIII (hemofilia A y IX (hemofilia B. La hemartrosis o hemorragia dentro de las articulaciones representa entre el 65-80% de todas las hemorragias en hemofílicos y determinan en gran parte el deterioro en la calidad de vida por su curso crónico e incapacitante. La osteoporosis es una enfermedad esquelética sistémica caracterizada por compromiso de la resistencia ósea que aumenta el riesgo de fractura. La hemofilia y la osteoporosis tienen varios aspectos en común: ambas enfermedades están acompañadas de dolor crónico, invalidez, pérdida de la independencia, aumento de la mortalidad y tienen un impacto negativo sobre la calidad de vida de los pacientes. La osteoporosis es la enfermedad metabólica ósea más frecuente en la población mayor, con alcances socioeconómicos importantes. No obstante, las hemofilias son menos comunes, pero los costos de su tratamiento global son más elevados. Aparte de estas obvias similitudes entre la hemofilia y la osteoporosis, se considera que hay una fuerte relación entre estas dos entidades más que la que se suponía antes, y los pacientes con hemofilia severa y artropatía hemofílica tienen mayor riesgo de tener un pico de masa ósea bajo. La hemofilia está asociada a varios factores que predicen un pico de masa ósea bajo y, ciertos de estos factores, también pueden predecir un aumento en la pérdida de la masa ósea; sin embargo, aún no se ha demostrado que la pérdida ósea sea mayor en hemofílicos más que en los controles sanos, ni el grado en el cual el pico de masa ósea baja confiere un aumento en el riesgo de fractura. Se necesitan estudios prospectivos antes de establecer gu

  12. An economic evaluation: Simulation of the cost-effectiveness and cost-utility of universal prevention strategies against osteoporosis-related fractures.

    Science.gov (United States)

    Nshimyumukiza, Léon; Durand, Audrey; Gagnon, Mathieu; Douville, Xavier; Morin, Suzanne; Lindsay, Carmen; Duplantie, Julie; Gagné, Christian; Jean, Sonia; Giguère, Yves; Dodin, Sylvie; Rousseau, François; Reinharz, Daniel

    2013-02-01

    A patient-level Markov decision model was used to simulate a virtual cohort of 500,000 women 40 years old and over, in relation to osteoporosis-related hip, clinical vertebral, and wrist bone fractures events. Sixteen different screening options of three main scenario groups were compared: (1) the status quo (no specific national prevention program); (2) a universal primary prevention program; and (3) a universal screening and treatment program based on the 10-year absolute risk of fracture. The outcomes measured were total directs costs from the perspective of the public health care system, number of fractures, and quality-adjusted life-years (QALYs). Results show that an option consisting of a program promoting physical activity and treatment if a fracture occurs is the most cost-effective (CE) (cost/fracture averted) alternative and also the only cost saving one, especially for women 40 to 64 years old. In women who are 65 years and over, bone mineral density (BMD)-based screening and treatment based on the 10-year absolute fracture risk calculated using a Canadian Association of Radiologists and Osteoporosis Canada (CAROC) tool is the best next alternative. In terms of cost-utility (CU), results were similar. For women less than 65 years old, a program promoting physical activity emerged as cost-saving but BMD-based screening with pharmacological treatment also emerged as an interesting alternative. In conclusion, a program promoting physical activity is the most CE and CU option for women 40 to 64 years old. BMD screening and pharmacological treatment might be considered a reasonable alternative for women 65 years old and over because at a healthcare capacity of $50,000 Canadian dollars ($CAD) for each additional fracture averted or for one QALY gained its probabilities of cost-effectiveness compared to the program promoting physical activity are 63% and 75%, respectively, which could be considered socially acceptable. Consideration of the indirect costs could

  13. [Osteoporosis: Current state of the art].

    Science.gov (United States)

    Verbovoy, A F; Pashentseva, A V; Sharonova, L A

    As of now, osteoporosis (OP) is one of the most important sociomedical problems because of its high prevalence and resultant disability, as well as significant mortality attributable to complications. The current strategy for providing care for patients of OP is its early diagnosis, by determining the high risk of fractures, and early pathogenetic treatment. The article gives an update on the epidemiology, risk factors, diagnosis, and treatment of OP.

  14. Osteoporosis: diagnosis and treatment

    International Nuclear Information System (INIS)

    Valino, J.; Mendoza, B.; Bozzola, J.; Vignolo, J.

    1997-01-01

    Osteoporosis represents an important problem in Public Health. It is defined a decrease in bone mass with changes in its microstructure and increased rich of fracture. This bone mass is under the influence of genetic, ethnic, nutrition environment and cultural factors. Usually, osteoporosis is asymptomatic until the occurrence of fracture that are the main morbidity element. Its study implies conventional radiologic methods, bone densitometry, bone remodelation markers and bone biopsy. The importance of prevention must be noted, as well as its treatment on the basis of exercise, calcium and hormonal substitution in the post menopause woman. Other drugs are vitamin D, bifosfonates, calcitonin and fluorine; the factors involved in bone growth on the course of experimentation [es

  15. Screening for osteoporosis

    International Nuclear Information System (INIS)

    Kasperk, C.

    2008-01-01

    Osteoporosis affects approximately 7 million patients in Germany and severely impairs quality of life. The clinical picture, subjective complaints as well as the presence or absence of risk factors are essential to determine the individual risk profile and to decide on possible serum blood tests, osteodensitometry, and X-ray examinations. Back pain or other clinical evidence of impaired bone stability should be evaluated with X-ray studies of the spine. If osteoporosis and an increased risk of fracture are present, treatment is indicated which includes an evidence-based pharmaceutical regimen in order to increase bone stability and to lower the risk of fractures. Drug treatment with adequate calcium and vitamin D supplementation and antiresorptive or osteoanabolic substances, usually for 3-5 years, should be accompanied by pain medication and neuromuscular rehabilitation to help prevent falls and maintain independence of the elderly. (orig.) [de

  16. Transient osteoporosis of hip

    Directory of Open Access Journals (Sweden)

    Mahesh M Choudhary

    2015-01-01

    Full Text Available We report a case of transient osteoporosis of the hip (TOH in a 50-year-old man including the clinical presentation, diagnostic studies, management, and clinical progress. TOH is a rare self-limiting condition that typically affects middle-aged men or, less frequently, women in the third trimester of pregnancy. Affected individuals present clinically with acute hip pain, limping gait, and limited ranges of hip motion. TOH may begin spontaneously or after a minor trauma. Radiographs are typically unremarkable but magnetic resonance (MR imaging studies yield findings consistent with bone marrow edema. TOH is referred to as regional migratory osteoporosis (RMO if it travels to other joints or the contralateral hip. TOH often resembles osteonecrosis but the two conditions must be differentiated due to different prognoses and management approaches. The term TOH is often used interchangeably and synonymously with transient bone marrow edema (TBME.

  17. Breastfeeding and postmenopausal osteoporosis.

    Science.gov (United States)

    Grimes, Julia P; Wimalawansa, Sunil J

    2003-06-01

    Bone loss associated with osteoporosis occurs with high frequency among the elderly and often results in debilitating fractures. A combination of lifestyle behaviors, genetic predisposition, and disease processes contributes to bone metabolism. Therefore, any discussion regarding bone health must address these factors. The impact of menopause on bone turnover has been generally well studied and characterized. Breastfeeding places significant stress on calcium metabolism and, as a consequence, directly influences bone metabolism. The most significant factors affecting bone mineral density (BMD) and bone metabolism are the duration and frequency of lactation, the return of menses, and pre-pregnancy weight. Although transient, lactation is associated with bone loss. As clinical guidelines and public health policies are being formulated, there is a compelling need for further investigation into the relationship of lactation, BMD, and subsequent risk of osteoporosis. Better understanding of this relationship will provide new opportunities for early intervention and ultimately help in the prevention of bone loss in postmenopausal women.

  18. [Glucocorticoid induced osteoporosis].

    Science.gov (United States)

    Anić, Branimir; Mayer, Miroslav

    2014-01-01

    Secondary osteoporosis most often develops due to glucocorticoid therapy. Glucocorticoids affect all stages of the bone remodeling cycle, its formation and resorption. Osteoblasts are primarily affected, decreasing their activity and enhancing apoptosis. Patients treated with glucocorticoids have lower bone mineral density and increased fracture risk. Glucocorticoid-induced osteoporosis can be prevented by administering the minimal effective dose of glucocorticoids, calcium and vitamin D supplementation or, if possible, by hormone replace- ment therapy. Moreover, appropriate physical activity should be encouraged. Patients who are at higher risk for low-energy fractures (for example post-menopausal women) have to be actively treated, usually with antiresorptive drugs among which bisphosphonates are currently the first line therapy.

  19. Teriparatide - Indications beyond osteoporosis

    Directory of Open Access Journals (Sweden)

    Marilyn Lee Cheng

    2012-01-01

    Full Text Available Osteoporosis is a condition of impaired bone strength that results in an increased risk of fracture. The current and most popular pharmacological options for the treatment of osteoporosis include antiresorptive therapy, in particular, oral bisphosphonates (alendronate, risedronate, ibandronate. Anabolic agents like teriparatide have widened our therapeutic options. They act by directly stimulating bone formation and improving bone mass quantity and quality. Two forms of recombinant human parathyroid hormone (PTH are available : full-length PTH (PTH 1-84; approved in the EU only and the 1-34 N-terminal active fragment of PTH (teriparatide, US FDA approved. This review aims to discuss the benefits of teriparatide beyond the currently licensed indications like fracture healing, dental stability, osteonecrosis of jaw, hypoparathyroidism, and hypocalcemia.

  20. Life cycle management at Ontario Power Generation

    International Nuclear Information System (INIS)

    Spekkens, P.

    2006-01-01

    This paper outlines the Life Cycle Management (LCM) program at Ontario Power Generation. LCM is carried out at different levels that includes components, systems, unit and fleet. A system involves cumulative effect of individual component aging. These components include steam generators, pressure tubes and feeders. A unit involves an overall unit aging strategy integrating all systems. At the fleet level, there is an optimal strategy for plant-level investments including end-of-life of a unit

  1. Osteoporosis and Periodontitis.

    Science.gov (United States)

    Wang, Chin-Wei Jeff; McCauley, Laurie K

    2016-12-01

    Osteoporosis and periodontitis are both diseases characterized by bone resorption. Osteoporosis features systemic degenerative bone loss that leads to loss of skeletal cancellous microstructure and subsequent fracture, whereas periodontitis involves local inflammatory bone loss, following an infectious breach of the alveolar cortical bone, and it may result in tooth loss. Most cross-sectional studies have confirmed the association of osteoporosis and periodontitis primarily on radiographic measurements and to a lesser degree on clinical parameters. Multiple shared risk factors include age, genetics, hormonal change, smoking, as well as calcium and vitamin D deficiency. Both diseases could also be risk factors for each other and have a mutual impact that requires concomitant management. Suggested mechanisms underlying the linkage are disruption of the homeostasis concerning bone remodeling, hormonal balance, and inflammation resolution. A mutual interventional approach is emerging with complex treatment interactions. Prevention and management of both diseases require interdisciplinary approaches and warrants future well-controlled longitudinal and interventional studies for evidence-based clinical guidelines.

  2. Fracture Risk and Risk Factors for Osteoporosis.

    Science.gov (United States)

    Schürer, Christian; Wallaschofski, Henri; Nauck, Matthias; Völzke, Henry; Schober, Hans-Christof; Hannemann, Anke

    2015-05-25

    As the population ages, diseases of the elderly are becoming more common, including osteoporosis. Ways to assess the risk of fracture and the distribution and effects of known risk factors for osteoporosis will be important in planning for future healthcare needs, as well as in the development of preventive strategies. The study population included 6029 men and women aged 20-90 who underwent examination in the second follow-up wave of the Study of Health in Pomerania (SHIP-2) or in the basal SHIP-Trend Study. The risk of fracture was estimated on the basis of quantitative ultrasonography of the calcaneus. Prior fractures and risk factors for osteoporosis were ascertained in standardized interviews. 4.6% of the male subjects and 10.6% of the female subjects were judged to have an elevated risk of fracture. The corresponding percentages among subjects over age 65 were 8.8% for men and 28.2% for women. Even among subjects under age 55, risk factors for osteoporosis were associated with lower bone stiffness: the mean stiffness index was 103/98 (men/women) without risk factors, 99/96 with one risk factor, and 93/95 with more than one risk factor. Logistic regression analysis yielded an odds ratio of 1.89 (95% confidence interval: 1.44-2.50; p<0.01) for prevalent fractures among subjects aged 75 and older compared to subjects under age 55. The data indicate a high prevalence of osteoporosis from age 65 onward. These findings are consistent with those of other studies from Germany and across Europe. Younger men and women should already begin taking steps to counteract modifiable risk factors.

  3. An interdisciplinary knowledge translation intervention in long-term care: Study protocol for the vitamin D and osteoporosis study (ViDOS pilot cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kennedy Courtney C

    2012-05-01

    Full Text Available Abstract Background Knowledge translation (KT research in long-term care (LTC is still in its early stages. This protocol describes the evaluation of a multifaceted, interdisciplinary KT intervention aimed at integrating evidence-based osteoporosis and fracture prevention strategies into LTC care processes. Methods and design The Vitamin D and Osteoporosis Study (ViDOS is underway in 40 LTC homes (n = 19 intervention, n = 21 control across Ontario, Canada. The primary objectives of this study are to assess the feasibility of delivering the KT intervention, and clinically, to increase the percent of LTC residents prescribed ≥800 IU of vitamin D daily. Eligibility criteria are LTC homes that are serviced by our partner pharmacy provider and have more than one prescribing physician. The target audience within each LTC home is the Professional Advisory Committee (PAC, an interdisciplinary team who meets quarterly. The key elements of the intervention are three interactive educational sessions led by an expert opinion leader, action planning using a quality improvement cycle, audit and feedback reports, nominated internal champions, and reminders/point-of-care tools. Control homes do not receive any intervention, however both intervention and control homes received educational materials as part of the Ontario Osteoporosis Strategy. Primary outcomes are feasibility measures (recruitment, retention, attendance at educational sessions, action plan items identified and initiated, internal champions identified, performance reports provided and reviewed, and vitamin D (≥800 IU/daily prescribing at 6 and 12 months. Secondary outcomes include the proportion of residents prescribed calcium supplements and osteoporosis medications, and falls and fractures. Qualitative methods will examine the experience of the LTC team with the KT intervention. Homes are centrally randomized to intervention and control groups in blocks of variable size using

  4. Transient osteoporosis of the hip

    International Nuclear Information System (INIS)

    McWalter, Patricia; Hassan Ahmed

    2007-01-01

    Transient osteoporosis of the hip is an uncommon cause of hip pain, mostly affecting healthy middle-aged men and also women in the third trimester of pregnancy. We present a case of transient osteoporosis of the hip in a 33-year-old non-pregnant female patient. This case highlights the importance of considering a diagnosis of transient osteoporosis of the hip in patients who present with hip pain. (author)

  5. Ontario Hydro decontamination experience

    Energy Technology Data Exchange (ETDEWEB)

    Lacy, C S; Patterson, R W; Upton, M S [Chemistry and Metallurgy Department, Central Production Services, Ontario Hydro, ON (Canada)

    1991-04-01

    Ontario Hydro currently operates 18 nuclear electric generating units of the CANDU design with a net capacity of 12,402 MW(e). An additional 1,762 MW(e) is under construction. The operation of these facilities has underlined the need to have decontamination capability both to reduce radiation fields, as well as to control and reduce contamination during component maintenance. This paper presents Ontario Hydro decontamination experience in two key areas - full heat transport decontamination to reduce system radiation fields, and component decontamination to reduce loose contamination particularly as practised in maintenance and decontamination centres. (author)

  6. Ontario Hydro decontamination experience

    International Nuclear Information System (INIS)

    Lacy, C.S.; Patterson, R.W.; Upton, M.S.

    1991-01-01

    Ontario Hydro currently operates 18 nuclear electric generating units of the CANDU design with a net capacity of 12,402 MW(e). An additional 1,762 MW(e) is under construction. The operation of these facilities has underlined the need to have decontamination capability both to reduce radiation fields, as well as to control and reduce contamination during component maintenance. This paper presents Ontario Hydro decontamination experience in two key areas - full heat transport decontamination to reduce system radiation fields, and component decontamination to reduce loose contamination particularly as practised in maintenance and decontamination centres. (author)

  7. Osteoporosis and Somatization of Anxiety

    Directory of Open Access Journals (Sweden)

    Maria Papanikou

    2013-12-01

    Full Text Available Chronic stress can now be physiologically traced as a significant player in the creation of osteoporotic bones. The present pilot study involved 100 women (N = 42 have been diagnosed with osteopenia, N = 21 have been diagnosed with osteoporosis, N = 37 had a non-osteoporotic condition who participated in the Hellenic Society of Osteoporosis Association Support. Correlations between somatic symptoms of anxiety and osteoporosis, and among medications and somatization in women were explored. Assessments were based on a self-report demographic questionnaire and on the Short Anxiety Screening Test (SAST administered for detection of anxiety disorder and somatization. Statistical analysis detected non-significant differences regarding the correlation between anxiety symptomatology or somatization due to osteoporosis and osteopenia diagnosis. The same pattern is observed among women’s age group, the occupational and marital status. Hypothesis that the osteoporosis and osteopenia group would manifest significant relationships with the age group and medicines was confirmed, as well as between somatization and medicines that women with osteoporosis and osteopenia undertake. The results suggest that women are not prone to manifest anxiety or somatization in relation to the osteoporosis condition. However, the majority of women with osteoporosis and osteopenia consume more than two medicines other than those for osteoporosis. This quantity and combination they undertake appear to contribute and deteriorate their anxiety/somatization symptomatology. Further research based on a larger sample would give more definite results.

  8. Osteoporosis in the European Union

    DEFF Research Database (Denmark)

    Svedbom, A; Hernlund, E; Ivergård, M

    2013-01-01

    the burden of osteoporosis in each of the EU27 countries in 2010 and beyond. METHODS: The data on fracture incidence and costs of fractures in the EU27 were taken from a concurrent publication in this journal (Osteoporosis in the European Union: Medical Management, Epidemiology and Economic Burden......UNLABELLED: This report describes epidemiology, burden, and treatment of osteoporosis in each of the 27 countries of the European Union (EU27). INTRODUCTION: In 2010, 22 million women and 5.5 million men were estimated to have osteoporosis in the EU; and 3.5 million new fragility fractures were...

  9. Bisphosphonates for osteoporosis in primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Rudic, Jelena; Giljaca, Vanja; Krstic, Miodrag N

    2011-01-01

    Bisphosphonates are widely used for treatment of postmenopausal osteoporosis. Patients with primary biliary cirrhosis often have osteoporosis - either postmenopausal or secondary to the liver disease. No systematic review or meta-analysis has assessed the effects of bisphosphonates for osteoporosis...

  10. Ontario Hydro statistical yearbook 1990

    International Nuclear Information System (INIS)

    1990-01-01

    Ontario Hydro was created in 1906 by a special statute of the Province of Ontario. It is a financially self-sustaining corporation without share capital. The yearbook is a compilation of financial data detailed by financial statements and sales and revenue figures for the year 1990. It is broken down by municipalities served in Ontario

  11. Ontario Hydro statistical yearbook 1990

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1991-12-31

    Ontario Hydro was created in 1906 by a special statute of the Province of Ontario. It is a financially self-sustaining corporation without share capital. The yearbook is a compilation of financial data detailed by financial statements and sales and revenue figures for the year 1990. It is broken down by municipalities served in Ontario.

  12. Determining the cut-off point of osteoporosis based on the osteoporosis self-assessment tool, body mass index and weight in Taiwanese young adult women.

    Science.gov (United States)

    Chang, Shu Fang; Yang, Rong Sen

    2014-09-01

    To examine the cut-off point of the osteoporosis self-assessment tool, age, weight and body mass index for osteoporosis among young adult Taiwanese women, using a large-scale health examination database containing bone mineral density tests. The cut-off points of osteoporosis risk factors identified earlier focus on menopausal or senior Caucasian and Asian women. However, young adult Asian women have seldom been identified. A retrospective historical cohort study. Using the 2009-2011 health examination database of a large-scale medical centre in northern Taiwan, this study investigated young adult Asian women (i.e. range in age from 30-49 years) in Taiwan who had received dual-energy X-ray absorptiometry test. This study also explored the cut-off point, sensitivity, specificity and diagnostic accuracy of receiver operating characteristics of osteoporosis among young adult females in Taiwan. This study collected 2454 young adult Asian women in Taiwan. Cochran-Armitage analysis results indicated that the prevalence of osteoporosis increased with decreasing weight, body mass index and osteoporosis self-assessment method quartiles. According to the results of receiver operating characteristics, weight, body mass index and osteoporosis self-assessment tool approaches can generally be used as indicators to predict osteoporosis among young adult Asian women. Results of this study demonstrate that Taiwanese women contracting osteoporosis tend to be young and underweight, as well as having a low body mass index and osteoporosis self-assessment scores. Those results further suggest that the assessment indicators for cut-off points are appropriately suitable for young adult women in Taiwan. Early detection is the only available means of preventing osteoporosis. Professional nurses should apply convenient and accurate assessment procedures to help young adult women to adopt preventive strategies against osteoporosis early, thus eliminating the probability of osteoporotic

  13. Retailers test Ontario market

    International Nuclear Information System (INIS)

    Kishewitsch, S.

    2000-01-01

    In anticipation of the full opening of the Ontario electricity market in November 2000, some of the newly-licensed electricity retailers are reported to be ready to begin testing the market early, hoping that all the uncertainties that still exist about pricing will be worked out in time. Among those jumping in now is Direct Energy Marketing, a retailer which claims 800,000 households in Ontario as electricity supply customers, as well as a wholesale gas marketing business. Direct Energy began retail electrical marketing on April 3, 2000, starting cautiously with small commercial operations as the initial target. Greengrid Electric, another of the new marketers, planned to begin marketing in mid-April, offering 100 per cent renewable-sourced electricity. Provident Energy Management, one of the new marketers whose licence is still pending, hopes to begin direct marketing as soon as its licence is confirmed. Another marketer ready to go as soon its license is issued is the former Sault Ste. Marie Hydro, now reorganized as PUC Energies Inc. PUC has the advantage of having a firm contract with a NUG (non-utility generator), Great Lakes Power, signed while PUC was still a municipal electric utility. As far as the other potential marketers are concerned, caution overrides opportunity for the present. Principal concerns are uncertainty over the retail settlement code, the electronic business data transfer system, transmission and distribution tariffs, whether existing non-utility generator contracts will allow for supply to another party, and over how quickly Ontario Power Generation Inc's (successor to Ontario Hydro) market power will be ratcheted down. Many of the potential marketers feel that despite the Ontario government's desire to see more competition, the power mitigation agreement, as it now reads, leaves little room for the small retailer to compete

  14. Retailers test Ontario market

    Energy Technology Data Exchange (ETDEWEB)

    Kishewitsch, S.

    2000-04-01

    In anticipation of the full opening of the Ontario electricity market in November 2000, some of the newly-licensed electricity retailers are reported to be ready to begin testing the market early, hoping that all the uncertainties that still exist about pricing will be worked out in time. Among those jumping in now is Direct Energy Marketing, a retailer which claims 800,000 households in Ontario as electricity supply customers, as well as a wholesale gas marketing business. Direct Energy began retail electrical marketing on April 3, 2000, starting cautiously with small commercial operations as the initial target. Greengrid Electric, another of the new marketers, planned to begin marketing in mid-April, offering 100 per cent renewable-sourced electricity. Provident Energy Management, one of the new marketers whose licence is still pending, hopes to begin direct marketing as soon as its licence is confirmed. Another marketer ready to go as soon its license is issued is the former Sault Ste. Marie Hydro, now reorganized as PUC Energies Inc. PUC has the advantage of having a firm contract with a NUG (non-utility generator), Great Lakes Power, signed while PUC was still a municipal electric utility. As far as the other potential marketers are concerned, caution overrides opportunity for the present. Principal concerns are uncertainty over the retail settlement code, the electronic business data transfer system, transmission and distribution tariffs, whether existing non-utility generator contracts will allow for supply to another party, and over how quickly Ontario Power Generation Inc's (successor to Ontario Hydro) market power will be ratcheted down. Many of the potential marketers feel that despite the Ontario government's desire to see more competition, the power mitigation agreement, as it now reads, leaves little room for the small retailer to compete.

  15. Quality of life in post-menopausal osteoporosis

    Directory of Open Access Journals (Sweden)

    Ortolani Sergio

    2005-12-01

    Full Text Available Abstract Background To evaluate the impact of osteoporosis on the patients' quality of life, particularly in the absence of fractures. Methods 100 post-menopausal women (age 50-85 - 62 with uncomplicated primary osteoporosis and 38 with primary osteoporosis complicated by vertebral fractures; all already treated - were studied using two validated questionnaires: Qualeffo-41 for quality of life in osteoporosis, and Zung for depression. Data were compared to those of 35 controls of comparable age, affected by a different chronic disease (hypothyroidism. Results Family history of osteoporosis and T-score of spine were similar in the two subgroups of osteoporotic women. Body mass index, age at menopause and education level were similar in the two subgroups of osteoporotic women and in the control group. The patients affected by osteoporosis perceived it as a disease affecting their personal life with undesirable consequences: chronic pain (66% of women with fractures and 40% of women without fractures, impaired physical ability, reduced social activity, poor well-being (21% of women without fractures and depressed mood (42% of women irrespective of fractures. Overall, 41% of the women showed a reduced quality of life. On the contrary, in the control group only 11% reported a reduced quality of life. Conclusion The quality of life of osteoporotic patients should be investigated even before fractures, in order to develop appropriate counselling, support and care interventions to help patients develop efficient strategies for accepting the disease and coping with it.

  16. Osteoporosis in older persons: current pharmacotherapy and future directions.

    Science.gov (United States)

    Duque, Gustavo

    2013-10-01

    Osteopororic fractures are highly prevalent in older persons having catastrophic consequences in their quality of life and increasing disability and mortality in this population. The mechanisms of osteoporosis in older persons are unique in terms of cellular changes and response to osteoporosis treatment. Therefore, specifically targeted treatments are required in this particular population. This paper provides an overview on the particular mechanisms of osteoporosis in older persons and the current and future therapeutic strategies to improve bone mass and prevent fractures in this population. Osteoporosis in older persons (especially in the old-old) has a unique pathophysiology that predisposes them to fractures thus having catastrophic consequences. Identification of patients at risk followed by therapies targeted to their cellular changes is pivotal to close the care gap observed in osteoporosis, predominantly in the older population. The treatment of osteoporosis has evolved from daily to yearly dosing thus facilitating compliance and effectiveness. It is expected that future biologically targeted treatments will have a similar separate dosing regime with better anti-fracture efficacy and lower incidence of side effects.

  17. The Potential Use of Agroforestry Community Gardens as a Sustainable Import-Substitution Strategy for Enhancing Food Security in Subarctic Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Maren Oelbermann

    2013-09-01

    Full Text Available The high prevalence of food insecurity experienced by northern First Nations partially results from dependence on an expensive import-based food system that typically lacks nutritional quality and further displaces traditional food systems. In the present study, the feasibility of import substitution by Agroforestry Community Gardens (AFCGs as socio-ecologically and culturally sustainable means of enhancing food security was explored through a case study of Fort Albany First Nation in subarctic Ontario, Canada. Agroforestry is a diverse tree-crop agricultural system that has enhanced food security in the tropics and subtropics. Study sites were selected for long-term agroforestry research to compare Salix spp. (willow-dominated AFCG plots to a “no tree” control plot in Fort Albany. Initial soil and vegetative analysis revealed a high capacity for all sites to support mixed produce with noted modifications, as well as potential competitive and beneficial willow-crop interactions. It is anticipated that inclusion of willow trees will enhance the long-term productive capacity of the AFCG test plots. As an adaptable and dynamic system, AFCGs have potential to act as a more reliable local agrarian system and a refuge for culturally significant plants in high-latitude First Nation socio-ecological systems, which are particularly vulnerable to rapid cultural, climatic, and ecological change.

  18. Magnesium and Osteoporosis

    Directory of Open Access Journals (Sweden)

    Ferda Özdemir

    2004-03-01

    Full Text Available Osteoporosis (OP is a condition of bone fragility resulting from micro-architectural deterioration and decreased bone mass. OP depends on the interaction of genetic, hormonal, environmental and nutritional factors. Chronic low intakes of vitamin D and possibly magnesium, zinc, fluoride and vitamins K, B12, B6 and folic acid may predispose to osteoporosis. Magnesium is a mineral needed by every cell of your body. It helps maintain normal muscle and nerve function, keeps heart rhythm steady, and bones strong. Mg serves as co-factors for enzymes that help build bone matrix. Magnesium deficiency occurs due to excessive loss of magnesium in urine, gastrointestinal system disorders that cause a loss of magnesium or limit magnesium absorption, or a chronic low intake of magnesium. Signs of magnesium deficiency include confusion, disorientation, loss of appetite, depression, muscle contractions and cramps, tingling, numbness, abnormal heart rhythms, coronary spasm, and seizures. Magnesium deficiency alters calcium metabolism and the hormones that regulates calcium. Several studies have suggested that magnesium supplementation may improve bone mineral density and prevent fractures.

  19. Microgravity and Osteoporosis - Review

    Directory of Open Access Journals (Sweden)

    Yeşim Kirazlı

    2006-09-01

    Full Text Available As human beings venture into space to travel to distant planets and to colonize, they will be confronted with osteoporosis that could put them at risk for fracture when they return to Earth. This paper reviews the possible mechanisms by which unloading of the skeleton -such as during space flight and scuba diving- results in rapid mobilization of calcium stores from the skeleton and also the interventions to stabilize bone loss in astronauts. Weightlessness increases urinary calcium excretion, decreases intestinal calcium absorption, and increases serum calcium level, with decreased levels of serum parathyroid hormone and calcitriol. Bone resorption is increased, whereas bone formation is decreased. The loss of bone mineral density (BMD in some regions of the skeleton is 1.0-2.0 % per month.. Countermeasure programs have depended solely upon exercise. However, osteogenic stimulus from exercise has been shown to be inadequate to maintain bone mass. There are also no data to show the efficacy of pharmaceutical agents for prevention of osteoporosis in astronauts. Trails using pharmaceutical agents in space are being planned. (Osteoporoz Dünyasından 2006;12:64-9

  20. Transient regional osteoporosis.

    Science.gov (United States)

    Cano-Marquina, Antonio; Tarín, Juan J; García-Pérez, Miguel-Ángel; Cano, Antonio

    2014-04-01

    Transient regional osteoporosis (TRO) is a disease that predisposes to fragility fracture in weight bearing joints of mid-life women and men. Pregnant women may also suffer the process, usually at the hip. The prevalence of TRO is lower than the systemic form, associated with postmenopause and advanced age, but may be falsely diminished by under-diagnosis. The disease may be uni- or bilateral, and may migrate to distinct joints. One main feature of TRO is spontaneous recovery. Pain and progressive limitation in the functionality of the affected joint(s) are key symptoms. In the case of the form associated with pregnancy, difficulties in diagnosis derive from the relatively young age at presentation and from the clinical overlapping with the frequent aches during gestation. Densitometric osteoporosis in the affected region is not always present, but bone marrow edema, with or without joint effusion, is detected by magnetic resonance. There are not treatment guidelines, but the association of antiresorptives to symptomatic treatment seems to be beneficial. Surgery or other orthopedic interventions can be required for specific indications, like hip fracture, intra-medullary decompression, or other. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Osteoporosis, Fractures, and Diabetes

    Directory of Open Access Journals (Sweden)

    Peter Jackuliak

    2014-01-01

    Full Text Available It is well established that osteoporosis and diabetes are prevalent diseases with significant associated morbidity and mortality. Patients with diabetes mellitus have an increased risk of bone fractures. In type 1 diabetes, the risk is increased by ∼6 times and is due to low bone mass. Despite increased bone mineral density (BMD, in patients with type 2 diabetes the risk is increased (which is about twice the risk in the general population due to the inferior quality of bone. Bone fragility in type 2 diabetes, which is not reflected by bone mineral density, depends on bone quality deterioration rather than bone mass reduction. Thus, surrogate markers and examination methods are needed to replace the insensitivity of BMD in assessing fracture risks of T2DM patients. One of these methods can be trabecular bone score. The aim of the paper is to present the present state of scientific knowledge about the osteoporosis risk in diabetic patient. The review also discusses the possibility of problematic using the study conclusions in real clinical practice.

  2. Wind power and bats : Ontario guideline

    Energy Technology Data Exchange (ETDEWEB)

    McGuiness, F. [Ontario Ministry of Natural Resources, Peterborough, ON (Canada). Renewable Energy Resources; Stewart, J. [Ontario Ministry of Natural Resources, Toronto, ON (Canada). Wildlife Section

    2008-07-01

    None of the 8 species of bats in Ontario are considered as species at risk. However, all bats in Ontario are protected under the Fish and Wildlife Conservation Act. The Ontario Ministry of Natural Resources (MNR) is responsible for identifying significant wildlife habitat for bats, including hibernacula and maternity roosts. The MNR's role in wind development includes environmental assessments (EA) and surveys. The MNR bat guideline includes a summary of Ontario species, a literature review of research related to wind turbines and bats, and a review of methods for assessing and monitoring bats. Guideline development includes a bat working group responsible for obtaining data on risk factors and monitoring requirements. The MNR has determined that site selection is critical for minimizing potential impacts. Wind farm proponents can use MNR data, information, and maps for their site selection process. Information requirements include bat species data; habitat data; and meteorological data. The presence of risk factors results in a sensitivity rating. The MNR is also developing a site sensitivity mapping project in order to assist proponents in making siting decisions. All proposed sites are required to conduct pre-construction site surveys. Acoustic detectors and radar are used to determine bat activity at the site. Monitoring and mitigation strategies include selective wind turbine shutdown during key periods or weather conditions. tabs., figs.

  3. Could martial arts fall training be safe for persons with osteoporosis?: a feasibility study.

    NARCIS (Netherlands)

    Groen, B.E.; Smulders, E.; Duysens, J.E.J.; Lankveld, W.G.J.M. van; Weerdesteijn, V.G.M.

    2010-01-01

    ABSTRACT: BACKGROUND: Osteoporosis is a well-established risk factor for fall-related hip fractures. Training fall arrest strategies, such as martial arts (MA) fall techniques, might be useful to prevent hip fractures in persons with osteoporosis, provided that the training itself is safe. This

  4. Ontario's uranium mining industry

    International Nuclear Information System (INIS)

    Runnalls, O.J.C.

    1981-01-01

    This report traces the Ontario uranium mining industry from the first discovery of uranium north of Sault Ste. Marie through the uranium boom of the 1950's when Elliot Lake and Bancroft were developed, the cutbacks of the 1960s, the renewed enthusiasm in exploration and development of the 1970s to the current position when continued production for the domestic market is assured. Ontario, with developed mines and operational expertise, will be in a position to compete for export markets as they reopen. The low level of expenditures for uranium exploration and the lack of new discoveries are noted. The report also reviews and places in perspective the development of policies and regulations governing the industry and the jurisdictional relationships of the Federal and Provincial governments

  5. Communicating about overdiagnosis: Learning from community focus groups on osteoporosis.

    Directory of Open Access Journals (Sweden)

    Ray Moynihan

    Full Text Available Overdiagnosis is considered a risk associated with the diagnosis of osteoporosis-as many people diagnosed won't experience harm from the condition. As yet there's little evidence on community understanding of overdiagnosis outside cancer- where it is an established risk of some screening programs-or effective ways to communicate about it. We examined community understanding around overdiagnosis of osteoporosis, to optimise communication strategies about this problem.Using a qualitative design we recruited a community sample of women, 50-80 years, from the Gold Coast community around Bond University, Australia, using random digit dialing, and conducted 5 focus groups with 41 women. A discussion guide and 4-part presentation were developed and piloted, with independent review from a consumer and clinical experts. Initial discussion had 4 segments: osteoporosis; bone density vs. other risk factors; medication; and overdiagnosis. The second half included the 4 short presentations and discussions on each. Analysis used Framework Analysis method. Initially participants described osteoporosis as bone degeneration causing some fear, demonstrated imprecise understanding of overdiagnosis, had a view osteoporosis couldn't be overdiagnosed as bone scans provided "clear cut" results, expressed belief in early diagnosis, and interest in prevention strategies enabling control. Following presentations, participants expressed some understanding of overdiagnosis, preference for describing osteoporosis as a "risk factor" not "disease", concern about a poor risk-benefit ratio for medications, and surprise and unease the definition of osteoporosis decided bone density of young women was "normal", without age adjustment. Limitations include English-speaking backgrounds of the sample and complex materials.Our findings suggest a gap between community expectations and how experts sometimes arbitrarily set low diagnostic thresholds which label those at risk as "diseased

  6. The osteoporosis pseudoglioma syndrome

    International Nuclear Information System (INIS)

    Swoboda, W.; Grill, F.

    1988-01-01

    Two siblings (male, 29 years, and female, 13 years) with the rare autosomal recessive osteoporosis pseudoglioma syndrome are reported in detail. All essential signs and symptoms of the full clinical picture were present and are documented by impressive X-ray pictures. Some aspects of our patients are compared with relevant findings of previous reports. Collagen studies (skin biopsies) failed to reveal any significant disorder of the main collagen types composition. Striking similarities with established genetic disorders of collagen (like the osteogenesis imperfecta group and the Ehlers-Danlos syndrome) suggest, however, that the OPS could be a primary collagen disorder. Genetic counselling and devoted socio-medical care for these handicapped children is presently the only help which can be offered. (orig.)

  7. Transient osteoporosis of pregnancy.

    Science.gov (United States)

    Maliha, George; Morgan, Jordan; Vrahas, Mark

    2012-08-01

    Transient osteoporosis of pregnancy (TOP) is a rare yet perhaps under-reported condition that has affected otherwise healthy pregnancies throughout the world. The condition presents suddenly in the third trimester of a usually uneventful pregnancy and progressively immobilizes the mother. Radiographic studies detect drastic loss of bone mass, elevated rates of turnover in the bone, and oedema in the affected portion. Weakness of the bone can lead to fractures during delivery and other complications for the mother. Then, within weeks of labour, symptoms and radiological findings resolve. Aetiology is currently unknown, although neural, vascular, haematological, endocrine, nutrient-deficiency, and other etiologies have been proposed. Several treatments have also been explored, including simple bed rest, steroids, bisphosphonates, calcitonin, induced termination of pregnancy, and surgical intervention. The orthopedist plays an essential role in monitoring the condition (and potential complications) as well as ensuring satisfactory outcomes for both the mother and newborn. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Screening for osteoporosis; Osteoporosescreening

    Energy Technology Data Exchange (ETDEWEB)

    Kasperk, C. [Medizinische Universitaetsklinik Heidelberg, Sektion Osteologie, Heidelberg (Germany)

    2008-01-15

    Osteoporosis affects approximately 7 million patients in Germany and severely impairs quality of life. The clinical picture, subjective complaints as well as the presence or absence of risk factors are essential to determine the individual risk profile and to decide on possible serum blood tests, osteodensitometry, and X-ray examinations. Back pain or other clinical evidence of impaired bone stability should be evaluated with X-ray studies of the spine. If osteoporosis and an increased risk of fracture are present, treatment is indicated which includes an evidence-based pharmaceutical regimen in order to increase bone stability and to lower the risk of fractures. Drug treatment with adequate calcium and vitamin D supplementation and antiresorptive or osteoanabolic substances, usually for 3-5 years, should be accompanied by pain medication and neuromuscular rehabilitation to help prevent falls and maintain independence of the elderly. (orig.) [German] Von der Volkskrankheit Osteoporose sind in Deutschland etwa 7 Mio. Patienten betroffen und sie traegt zu einer betraechtlichen Einschraenkung der Lebensqualitaet bei. Das klinische Beschwerdebild, die Anamnese und Evaluation von Risikofaktoren fuer das Vorliegen einer Osteoporose erlauben in erster Naeherung die Einschaetzung eines individuellen Osteoporoserisikoprofils. Auf der Grundlage dieses Risikoprofils ist erst dann die Indikation fuer eine weitere osteodensitometrische und laborchemische Diagnostik gegeben. Bestehen Rueckenschmerzen oder ein klinischer Anhalt fuer roentgenmorphologisch erkennbare knoecherne Veraenderungen, sollte zumindest einmalig eine Roentgenuntersuchung der BWS und LWS erfolgen. Bestaetigt sich der Verdacht auf eine osteoporotische Knochenfestigkeitsminderung mit einem entsprechend erhoehten Frakturrisiko, kann unter Beruecksichtigung auch des Alters die Indikation fuer eine Therapie gestellt werden. Es steht eine grosse Zahl evidenzbasierter pharmakologischer Therapiekonzepte zur

  9. Ontario Hydro annual report 1985

    International Nuclear Information System (INIS)

    1986-04-01

    Ontario Hydro is a corporation without share capital created by a special statute of the Province of Ontario in 1906. It now operates under the authority of the Power Corporation Act, R.S.O. 1980, Chapter 384, as amended, with broad powers to generate, supply and deliver electric power throughout the province. It is also authorized to produce and sell steam and hot water as primary products. The Corporation's prime objective is to supply the people of Ontario with electricity at the lowest feasible cost consistent with high safety and quality of service standards. Ontario Hydro's main activity is wholesaling electric power to municipal utilities in urban areas who, in turn, retail it to customers in their service areas. In 1985, approximately 3,166,000 customers were served by Ontario Hydro and the municipal utilities in the province. Ontario Hydro operates 81 hydraulic, fossil and nuclear generating stations and an extensive power grid across Ontario to meet the province's demands for electric energy. Interconnections with other systems place the Corporation in an extensive electrical grid that covers a large segment of the North American continent. Ontario Hydro is a financially self-sustaining corporation. The Province of Ontario guarantees bonds and notes issued to the public by the Corporation

  10. Low bone mass prevalence and osteoporosis risk factor assessment in African American Wisconsin women.

    Science.gov (United States)

    Kidambi, Srividya; Partington, Susan; Binkley, Neil

    2005-11-01

    Post-menopausal osteoporosis is seen in all racial groups. With the increasing population and longevity of minority groups, osteoporosis is becoming an important health concern. Data regarding risk factors for, and prevalence of, low bone mass and awareness of osteoporosis risk in African American (AA) women are limited. This article evaluates the risk factors for, and prevalence of, low bone mass in a population of urban AA women in Wisconsin and assesses this group's perceived risk for osteoporosis. One hundred fifty consecutive community-dwelling AA women > or = 45 years old from Milwaukee, Wis were asked to complete a questionnaire based on currently accepted osteoporosis risk factors. Additionally, their perception of osteoporosis risk was assessed using a Likert scale. All subjects underwent quantitative calcaneal ultrasound. Subject mean age was 54 +/- 7 years. Mean T- and Z-scores were 0.5 and 0.4, respectively. Applying World Health Organization criteria, osteopenia (bone mineral density T-score 2 children), postmenopausal state, and current smoking were associated with lower calcaneal bone mass. Higher education and presence of diabetes were associated with a higher bone mass. Only 25% of the women surveyed thought they were at moderate to high risk for osteoporosis. Low bone mass was present in 33% of these AA women despite their relative young age. Many AA women do not perceive osteoporosis as a health risk. It is necessary to develop strategies to educate AA women regarding osteoporosis risk.

  11. Osteoporosis and Asian American Women

    Science.gov (United States)

    ... and Asian American Women Osteoporosis and Asian American Women Asian American women are at high risk for ... medications. Are There Any Special Issues for Asian Women Regarding Bone Health? Recent studies indicate a number ...

  12. Severe heparin osteoporosis in pregnancy.

    OpenAIRE

    Griffiths, H. T.; Liu, D. T.

    1984-01-01

    A case of severe osteoporosis following administration of low dose subcutaneous heparin in pregnancy is reported. Possible reasons for the condition are suggested which caution against the indiscriminate use of subcutaneous heparin in pregnancy.

  13. Tonifying Shen-Yin and -Yang Principles in Treating Osteoporosis: All Roads Lead to Rome

    Directory of Open Access Journals (Sweden)

    Wei Gou

    2016-12-01

    Full Text Available Tonifying Shen strategy works as an important alternative and complementary method that is widely used to treat osteoporosis in Traditional Chinese Medicine (TCM based on the proper identification of Zheng. Shen deficiency Zheng is one of the main types of osteoporosis while Shen-Yin and -Yang deficiencies represent two basic principles/types of Shen deficiency. Currently, Tonifying Shen strategy, in particular, the Tonifying Shen-Yin and -Yang principles, has been demonstrated to exert osteoprotective effects. However, the mechanisms by which Tonifying Shen strategy and/or Tonifying Shen-Yin and -Yang principles function in treating osteoporosis are still not clearly understood. Here we first briefly explore current understanding of Tonifying Shen strategy, such as Tonifying Shen prescriptions, herbs, and effective components, in treating osteoporosis. Furthermore, the mechanism of Tonifying Shen-Yang principle in treating osteoporosis is reviewed from the clinic experience, animal, and mechanistic investigation. Moreover, the mechanisms by which Tonifying Shen-Yin principle in treating osteoporosis are established. Finally, we compare the similarity and difference between Tonifying Shen-Yang and -Yin principles in treating osteoporosis. Our findings indicate that both principles exert bone-protective effects in treating osteoporosis by simultaneously stimulating the differentiation of mesenchymal stem cells (MSCs into osteoblast and the differentiation of hematopoietic stem cells (HSCs into osteoclast. However, Tonifying Shen-Yin principle is in favor of increasing bone mineral density (BMD while Tonifying Shen-Yang principle is in favor of osteoporosis-related syndromes. Our findings indicate that Tonifying Shen-Yin and -Yang principles not only share some similarity but also obtain some difference in treating osteoporosis.

  14. Radiotherapy of presenile spinal osteoporosis

    International Nuclear Information System (INIS)

    Keim, H.M.; Schiebusch, M.

    1982-01-01

    Painfull conditions of presenile spinal osteoporosis may no longer respond to medication or physical therapy. Analgesic radiotherapy coupled with mild physical therapy and if necessary supported by orthopedic measures frequently results in pain relief and physical stability. Fifty-two cases of osteoporosis and osteoporotic spinal fractures illustrate how better longterm results are achieved by increasing the customary dosage and speeding up radiotherapy. (orig.) [de

  15. Osteoporosis in men: a review

    OpenAIRE

    Adler, Robert A

    2014-01-01

    Osteoporosis and consequent fracture are not limited to postmenopausal women. There is increasing attention being paid to osteoporosis in older men. Men suffer osteoporotic fractures about 10 years later in life than women, but life expectancy is increasing faster in men than women. Thus, men are living long enough to fracture, and when they do the consequences are greater than in women, with men having about twice the 1-year fatality rate after hip fracture, compared to women. Men at high ri...

  16. Diagnosis and management of osteoporosis in the older senior

    Directory of Open Access Journals (Sweden)

    Sheryl F Vondracek

    2009-03-01

    Full Text Available Sheryl F Vondracek, Sunny A LinneburDepartment of Clinical Pharmacy, School of Pharmacy C238-L15, University of Colorado Denver, Aurora, CO, USAAbstract: The older senior is at high risk for osteoporosis. It is important for healthcare providers to be fully aware of the potential risks and benefits of diagnosing and treating osteoporosis in the older senior population. Data indicate that bone mineral density testing is under-utilized and drug therapy is often not initiated when indicated in this population. Bone mineral density testing with central dual energy x-ray absorptiometry is essential and cost-effective in this population. All older seniors should be educated on a bone-healthy lifestyle including age-appropriate weightbearing exercise and smoking cessation if necessary. It is important to remember that falls play a very important role in the risk for osteoporotic fractures, especially in the older senior. All older seniors should be evaluated annually for falls and strategies should be implemented to reduce fall risk in this population. The risk for vitamin D insufficiency and deficiency is high in the older senior and can contribute to falls and fractures. Adequate intakes of calcium and vitamin D are important and deficiencies need to be treated. Data on osteoporosis drug therapy in the older senior are lacking. Based on data from subgroup analyses of large osteoporosis trials in postmenopausal women, current osteoporosis therapies appear safe and efficacious in the older senior and most will live long enough to derive a benefit from these therapies. Further studies are needed in older seniors, especially men, to better understand the risks and benefits of pharmacologic therapy for the management of osteoporosis.Keywords: osteoporosis, aged, elderly, eighty and over, senior, diphosphonates

  17. Osteoporosis: Implications for Risk Reduction in the College Setting.

    Science.gov (United States)

    Leslie, Maryann; St. Pierre, Richard W.

    1999-01-01

    Examines risk factors for osteoporosis that are especially relevant to the college health setting, focusing on bone development, inadequate calcium and vitamin D intake, cigarette smoking and alcohol use, steroid use and high protein diets, and physical inactivity and excessive exercise. Also presents intervention strategies for college health…

  18. Protective effect of Rhizoma drynariae extract on osteoporosis in ...

    African Journals Online (AJOL)

    has been a popular therapeutic strategy designed for postmenopausal osteoporosis [8,9]. However, the long-term application of HRT has potential malignant effects on reproductive tissues [10-13]. Other medicines that stimulate bone formation (e.g., growth hormone, sodium uoride, and parathyroid hormone) or inhibit bone.

  19. Ontario Hydro CANDU operating experience

    International Nuclear Information System (INIS)

    Jackson, H.A.; Woodhead, L.W.; Fanjoy, G.R.

    1984-03-01

    The CANDU Pressurized Heavy Water (CANDU-PHW) type of nuclear-electric generating station has been developed jointly by Atomic Energy of Canada Limited and Ontario Hydro. This report highlights Ontario Hydro's operating experience using the CANDU-PHW system, with a focus on the operating performance and costs, reliability of system components and nuclear safety considerations for the workers and the public

  20. Ontario Hydro CANDU operating experience

    International Nuclear Information System (INIS)

    Bartholomew, R.W.; Woodhead, L.W.; Horton, E.P.; Nichols, M.J.; Daly, I.N.

    1987-01-01

    The CANDU Pressurized Heavy Water (CANDU-PHW) type of nuclear-electric generating station has been developed jointly by Atomic Energy of Canada Limited and Ontario Hydro. This report highlights Ontario Hydro's operating experience using the CANDU-PHW system, with a focus on worker and public safety, operating performance and costs, and reliability of system components

  1. Ontario Hydro annual report 1975

    International Nuclear Information System (INIS)

    A financial report and statistics on Ontario energy demand are presented. Efforts to secure a reliable supply of coal and uranium are described. Ontario Hydro's expansion is now controlled by capital availability and not power demand, and this has affected 11 construction projects, including heavy water plants and nuclear generating stations. (E.C.B.)

  2. Osteoporosis and the Management of Spinal Degenerative Disease (II)

    Science.gov (United States)

    Tomé-Bermejo, Félix; Piñera, Angel R.; Alvarez, Luis

    2017-01-01

    Osteoporosis has become a major medical problem as the aged population of the world rapidly grows. Osteoporosis predisposes patients to fracture, progressive spinal deformities, and stenosis, and is subject to be a major concern before performing spine surgery, especially with bone fusions and instrumentation. Osteoporosis has often been considered a contraindication for spinal surgery, while in some instances patients have undergone limited and inadequate procedures in order to avoid concomitant instrumentation. As the population ages and the expectations of older patients increase, the demand for surgical treatment in older patients with osteoporosis and spinal degenerative diseases becomes progressively more important. Nowadays, advances in surgical and anesthetic technology make it possible to operate successfully on elderly patients who no longer accept disabling physical conditions. This article discusses the biomechanics of the osteoporotic spine, the diagnosis and management of osteoporotic patients with spinal conditions, as well as the novel treatments, recommendations, surgical indications, strategies and instrumentation in patients with osteoporosis who need spine operations. PMID:29299490

  3. Advances in osteoporosis imaging

    International Nuclear Information System (INIS)

    Bauer, Jan S.; Link, Thomas M.

    2009-01-01

    In the assessment of osteoporosis, the measurement of bone mineral density (BMD a ) obtained from dual energy X-ray absorptiometry (DXA; g/cm 2 ) is the most widely used parameter. However, bone strength and fracture risk are also influenced by parameters of bone quality such as micro-architecture and tissue properties. This article reviews the radiological techniques currently available for imaging and quantifying bone structure, as well as advanced techniques to image bone quality. With the recent developments in magnetic resonance (MR) techniques, including the availability of clinical 3 T scanners, and advances in computed tomography (CT) technology (e.g. clinical Micro-CT), in-vivo imaging of the trabecular bone architecture is becoming more feasible. Several in-vitro studies have demonstrated that bone architecture, measured by MR or CT, was a BMD-independent determinant of bone strength. In-vivo studies showed that patients with, and without, osteoporotic fractures could better be separated with parameters of bone architecture than with BMD. Parameters of trabecular architecture were more sensitive to treatment effects than BMD. Besides the 3D tomographic techniques, projection radiography has been used in the peripheral skeleton as an additional tool to better predict fracture risk than BMD alone. The quantification of the trabecular architecture included parameters of scale, shape, anisotropy and connectivity. Finite element analyses required highest resolution, but best predicted the biomechanical properties of the bone. MR diffusion and perfusion imaging and MR spectroscopy may provide measures of bone quality beyond trabecular micro-architecture.

  4. Osteoporosis and diabetes

    Directory of Open Access Journals (Sweden)

    M. Barbagallo

    2011-09-01

    Full Text Available Diabetes mellitus and osteoporosis are chronic diseases with an elevated and growing incidence in the elderly. Recent epidemiological studies have demonstrated an elevated risk of hip, humerus and foot fractures in elder diabetic subjects. While type 1 diabetes is generally associated with a mild reduction in bone mineral density (BMD, type 2 diabetes, more prevalent in old subjects, is frequently linked to a normal or high BMD. Studies on experimental models of diabetes have suggested an altered bone structure that may help to explain the elevated risk of fractures observed in these animals and may as well help to explain the paradox of an incremented risk of fractures in type 2 diabetic elderly in the presence of normal or elevated BMD. In addition, diabetic elderly have an increased risk of falls, consequent at least in part to a poor vision, peripheral neuropathy, and weaken muscular performance. Diabetes may affect bone tissue by different mechanisms including obesity, hyperinsulinemia, deposit of advanced glycosilation end products in collagen fibre, reduced circulating levels of IGF-1, hypercalciuria, renal function impairment, microangiopathy and chronic inflammation. A better understanding of these mechanisms may help implement the prevention of fractures in the growing population of mature diabetics.

  5. Ontario regulatory update

    International Nuclear Information System (INIS)

    Thompson, P.

    1998-01-01

    This paper provides a summary of recent events which when combined add up to a gradual but unmistakable movement of the energy sector in Ontario towards a fully competitive market. Some of the events precipitating this movement towards competition include the passing of the Energy Competition Act of 1998 (Bill 35), electricity deregulation, regulatory reform of the natural gas sector, and changes to the consumer protection legislation. The role of the Ontario Energy Board was also updated to bring it in line with the demands of the competitive marketplace. Among the new roles that the Board will assume are to facilitate competition, to maintain fair and reasonable rates, and to facilitate rational expansion. Another objective is to provide opportunities for including energy efficiency in government policies. Implications of the changes in the OEB's mandate for market participants were also discussed, including (1) regulated gas sales and delivery mechanisms, (2) transactional services, (3) contract restructuring, (4) consumer protection, (5) supervision of competitive market participants, and (6) market surveillance

  6. Ontario electricity bill review

    International Nuclear Information System (INIS)

    O'Neill, G.

    2003-01-01

    Findings of an independent review of charges to electricity bills and recommendations to assist in the development of a standard, province-wide residential electricity bill for Ontario are discussed. The review was requested by the province's Minister of Energy in an effort to dispel growing confusion about the variations in customer billing practices used by the province's 90+ local distribution companies. Key recommendations and findings were as follows: (1)Consumer bill formats issued by local distribution companies should be more consumer-friendly, adhere to minimum design standards, adapt uniform terminology and common line charges; (2) charges on customer bills should be grouped into four standard line items, with full details available to customers: the four line items should be a basic service charge, a charge for delivering electricity to the customer, a charge for the electricity itself, and a separate charge for retiring the outstanding debt of the former Ontario Hydro; (3) bills should take advantage of opportunities for promoting province-wide energy conservation, such as encouraging the long-term use of interval meters, presenting historical consumption data on residential bills on a period-to-period basis, and education and communications initiatives. Details of the recommendations, including the calculation of the fixed and variable components of usage charges, an explanation of the concept of electricity system loss adjustments, a method for phasing in the recommendations, and the anticipated benefits to consumers are provided

  7. For People with Osteoporosis: How to Find a Doctor

    Science.gov (United States)

    ... With Osteoporosis: How to Find a Doctor For People With Osteoporosis: How to Find a Doctor Isabel ... a doctor with expertise in osteoporosis. For many people, finding a doctor who is knowledgeable about osteoporosis ...

  8. Meanings of Success and Successful Leadership in Ontario, Canada, in Neo-Liberal Times

    Science.gov (United States)

    Winton, Sue; Pollock, Katina

    2016-01-01

    The provincial government of Ontario, Canada, has committed itself to raising student achievement, closing achievement gaps, and increasing the public's confidence in public education. It has introduced many policies, including the Ontario Leadership Strategy (OLS), to support these goals. Our study examined how teachers, administrators, support…

  9. Clinical Telemedicine Utilization in Ontario over the Ontario Telemedicine Network.

    Science.gov (United States)

    O'Gorman, Laurel D; Hogenbirk, John C; Warry, Wayne

    2016-06-01

    Northern Ontario is a region in Canada with approximately 775,000 people in communities scattered across 803,000 km(2). The Ontario Telemedicine Network (OTN) facilitates access to medical care in areas that are often underserved. We assessed how OTN utilization differed throughout the province. We used OTN medical service utilization data collected through the Ontario Health Insurance Plan and provided by the Ministry of Health and Long Term Care. Using census subdivisions grouped by Northern and Southern Ontario as well as urban and rural areas, we calculated utilization rates per fiscal year and total from 2008/2009 to 2013/2014. We also used billing codes to calculate utilization by therapeutic area of care. There were 652,337 OTN patient visits in Ontario from 2008/2009 to 2013/2014. Median annual utilization rates per 1,000 people were higher in northern areas (rural, 52.0; urban, 32.1) than in southern areas (rural, 6.1; urban, 3.1). The majority of usage in Ontario was in mental health and addictions (61.8%). Utilization in other areas of care such as surgery, oncology, and internal medicine was highest in the rural north, whereas primary care use was highest in the urban south. Utilization was higher and therapeutic areas of care were more diverse in rural Northern Ontario than in other parts of the province. Utilization was also higher in urban Northern Ontario than in Southern Ontario. This suggests that telemedicine is being used to improve access to medical care services, especially in sparsely populated regions of the province.

  10. Osteoporosis secundaria y Osteoporosis inducida por glucocorticoides (OIG

    Directory of Open Access Journals (Sweden)

    Elías Forero Illera

    2006-01-01

    Full Text Available La osteoporosis es un problema de salud pública importante a nivel mundial, y su prevalencia está aumentando. La osteoporosis secundaria se puede producir por varias patologías y el uso de ciertos medicamentos. Los glucocorticoides son un grupo de fármacos usados extensamente en la práctica médica debido a su indiscutible utilidad. La osteoporosis inducida por glucocorticoides es un problema de salud pública. Aunque la patogénesis de la pérdida producida por los glucocorticoides en el hueso no se conoce totalmente, investigaciones recientes han proporcionado nuevas conocimientos en los mecanismos de estos fármacos a nivel celular y molecular. Diversas guías han sido propuestas por diversos grupos para el tratamiento de la OIG; desafortunadamente, las guías del tratamiento no se utilizan adecuadamente en los pacientes.

  11. [Secondary osteoporosis induced by anticoagulants?].

    Science.gov (United States)

    Riess, H; Loew, A; Himmelreich, G

    2001-07-01

    Generalized osteoporosis is a result of different causes and pathogenic mechanisms, which often combine forces to become clinically relevant. Among the different exogenic factors, drugs play an important role, frequently in connection with other factors such as immobilization or pregnancy. It has been suggested that anticoagulation therapy with heparins or coumarins may induce osteoporotic changes or enhance the development of osteoporosis for other reasons. According to in vitro experiments, preclinical trials, and clinical investigations, it seems reasonable to assume that heparins induce increased bone loss in a time- and dose-related manner. Low-molecular-weight heparins most likely have less effect on bone turnover when compared to unfractionated heparin. Oral anticoagulation therapy with vitamin K-antagonists is believed to have a weak effect on induction of osteoporosis, but clinical studies are contradictory. In spite of the fact that a relevant effect of these drugs on the induction of osteoporosis is questionable, it must be taken into consideration that anticoagulant drugs may enhance the negative effects on bone density of other risk factors capable of inducing osteoporosis such as immobilization, pregnancy, or endocrinological disorders.

  12. [Pharmacologic treatment of osteoporosis--2011].

    Science.gov (United States)

    Lakatos, Péter

    2011-08-14

    Osteoporosis affects approximately 9% of the population in Hungary resulting in about 100 000 osteoporotic fractures annually. Thirty-five percent of patients with hip fractures due to osteoporosis will die within 1 year. Direct costs of osteoporosis exceed 25 billion forints per year. Apparently, cost-effective reduction of bone loss and consequent fracture risk will add up to not only financial savings but improvement in quality of life, as well. A number of pharmacological modalities are available for this purpose. The mainstay of the treatment of osteoporosis is the bisphosphonate group that includes effective anti-resorptive compounds mitigating bone loss and fragility. The recently registered denosumab exhibits similar efficacy by neutralizing RANK ligand, however, marked differences can be observed between the two drug classes. Strontium has a unique mechanism of action by rebalancing bone turnover, and thus, providing an efficient treatment option for the not fast bone losers who are at high fracture risk. The purely anabolic teriparatide is available for the extremely severe osteoporotic patients and for those who do not respond to other types of therapy. Older treatment options such as hormone replacement therapy, raloxifene, tibolone or calcitonin may also have a restricted place in the management of osteoporosis.

  13. Antidepressant medications and osteoporosis.

    Science.gov (United States)

    Rizzoli, R; Cooper, C; Reginster, J-Y; Abrahamsen, B; Adachi, J D; Brandi, M L; Bruyère, O; Compston, J; Ducy, P; Ferrari, S; Harvey, N C; Kanis, J A; Karsenty, G; Laslop, A; Rabenda, V; Vestergaard, P

    2012-09-01

    Use of antidepressant medications that act on the serotonin system has been linked to detrimental impacts on bone mineral density (BMD), and to osteoporosis. This article reviews current evidence for such effects, and identifies themes for future research. Serotonin receptors are found in all major types of bone cell (osteoblasts, osteocytes, and osteoclasts), indicating an important role of the neuroendocrine system in bone. Observational studies indicate a complex relationship between depression, antidepressants, and fracture. First, the presence of depression itself increases fracture risk, in relation with decreased BMD and an increase in falls. A range of aspects of depression may operate, including behavioral factors (e.g., smoking and nutrition), biological changes, and confounders (e.g., comorbidities and concomitant medications). A substantial proportion of depressed patients receive antidepressants, mostly selective serotonin reuptake inhibitors (SSRIs). Some of these have been linked to decreased BMD (SSRIs) and increased fracture risk (SSRIs and tricyclic agents). Current use of SSRIs and tricyclics increases fracture risk by as much as twofold versus nonusers, even after adjustment for potential confounders. While there is a dose-response relationship for SSRIs, the effect does not appear to be homogeneous across the whole class of drugs and may be linked to affinity for the serotonin transporter system. The increase in risk is the greatest in the early stages of treatment, with a dramatic increase after initiation, reaching a peak within 1 month for tricyclics and 8 months for SSRIs. Treatment-associated increased risk diminishes towards baseline in the year following discontinuation. The body of evidence suggests that SSRIs should be considered in the list of medications that are risk factors for osteoporotic fractures. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Public priorities for osteoporosis and fracture research: results from a general population survey.

    Science.gov (United States)

    Paskins, Zoe; Jinks, Clare; Mahmood, Waheed; Jayakumar, Prakash; Sangan, Caroline B; Belcher, John; Gwilym, Stephen

    2017-12-01

    This is the first national study of public and patient research priorities in osteoporosis and fracture. We have identified new research areas of importance to members of the public, particularly 'access to information from health professionals'. The findings are being incorporated into the research strategy of the National Osteoporosis Society. This study aimed to prioritise, with patients and public members, research topics for the osteoporosis research agenda. An e-survey to identify topics for research was co-designed with patient representatives. A link to the e-survey was disseminated to supporters of the UK National Osteoporosis Society (NOS) in a monthly e-newsletter. Responders were asked to indicate their top priority for research across four topics (understanding and preventing osteoporosis, living with osteoporosis, treating osteoporosis and treating fractures) and their top three items within each topic. Descriptive statistics were used to describe demographics and item ranking. A latent class analysis was applied to identify a substantive number of clusters with different combinations of binary responses. One thousand one hundred eighty-eight (7.4%) respondents completed the e-survey. The top three items overall were 'Having easy access to advice and information from health professionals' (63.8%), 'Understanding further the safety and benefit of osteoporosis drug treatments' (49.9%) and 'Identifying the condition early by screening' (49.2%). Latent class analysis revealed distinct clusters of responses within each topic including primary care management and self-management. Those without a history of prior fracture or aged under 70 were more likely to rate items within the cluster of self-management as important (21.0 vs 12.9 and 19.8 vs 13.3%, respectively). This is the first study of public research priorities in osteoporosis and has identified new research areas of importance to members of the public including access to information. The findings

  15. Is there a future for coal in Ontario?

    International Nuclear Information System (INIS)

    Davies, G.

    2004-01-01

    This PowerPoint presentation examined the efficacy of a governmental decision in 2003 to close all Ontario coal stations by 2007. Coal currently represents one quarter of Ontario's energy and capacity. Projected supply and demand gaps for Ontario were presented for up to 2020. Ontario's supply options were outlined. It was noted that between $30 and $40 billion in investment in the electricity sector will be needed over the next 10 to 15 years. It was observed that closing coal plants may reduce pollution by 6 per cent at a cost of $2 billion. More than half the smog affecting Ontario comes from the United States, while much of the remaining half is caused by transportation emissions. Details of energy strategies related to coal in the United States were discussed. New coal power plant technologies include supercritical combustion; advanced air pollution control; circulating fluidized bed combustion and integrated coal gasification combined cycles. Coal power plant performance criteria were presented. Various research programs in the United States were reviewed, and roadmap performance targets were presented. It was concluded that high prices and uncertainty for natural gas fired options may reinforce views on the need to rethink coal closures. A strategy was recommended in which Ontario pursued economic options for reducing emissions across all sectors. New investments in latest and best technology for emissions reduction in Ontario's coal-fired stations were recommended, as well as a North American agreement on clean air, and increased Canadian participation in U.S. technology development efforts for clean coal and zero emissions plants by 2025. tabs., figs

  16. Ontario Hydro's nuclear program

    International Nuclear Information System (INIS)

    Jackson, H.A.

    1982-06-01

    In 1981 Ontario Hydro generated over 100 billion KWh of electrical energy. Approximately one third of this was from nuclear units. There are ten CANDU units (5 250 MW) currently in operation, and another twelve (8 600 MW) are under construction. The presently committed nuclear expansion program is estimated to involve expenditures of 16 billion dollars over the next 10 years. About 10 000 people are employed in the nuclear design and construction program. All projects are generally on schedule, with the stations coming into service during the following time periods: Pickering B, 1983-85; Bruce B, 1984-87; Darlington, 1988-90. The status of each project is reviewed. Planning is underway for some retubing projects, as early as 1985 for Pickering A

  17. Nutritional risk factors for postmenopausal osteoporosis

    OpenAIRE

    Olfa Berriche; Amrouche Chiraz; Rym Ben Othman; Hamdi Souheila; Ines Lahmer; Chaabani Wafa; Imen Sebai; Haifa Sfar; Feten Mahjoub; Henda Jamoussi

    2017-01-01

    Background: Osteoporosis is a bone disease that combines both a decrease in bone density and its internal architecture changes. Nutrition is one of the major determinants of osteoporosis. Aim: The purpose of our study was to identify nutritional risk factors of osteoporosis of two groups of osteoporotic women and witnesses. Methods: We conducted a comparative cross-sectional study including 60 postmenopausal women and screening for osteoporosis by a bone densitometry, recruited the outp...

  18. SCOPE: a scorecard for osteoporosis in Europe

    OpenAIRE

    Kanis, J. A.; Borgström, F.; Compston, J.; Dreinhöfer, K.; Nolte, E.; Jonsson, L.; Lems, W. F.; McCloskey, E. V.; Rizzoli, R.; Stenmark, J.

    2013-01-01

    The scorecard summarises key indicators of the burden of osteoporosis and its management in each of the member states of the European Union. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. Introduction: The scorecard for osteoporosis in Europe (SCOPE) is an independent project that seeks to raise awareness of osteoporosis care in Europe. The aim of this project was to develop a scorecard and background documents to...

  19. Nutritional risk factors for postmenopausal osteoporosis | Berriche ...

    African Journals Online (AJOL)

    Background: Osteoporosis is a bone disease that combines both a decrease in bone density and its internal architecture changes. Nutrition is one of the major determinants of osteoporosis. Aim: The purpose of our study was to identify nutritional risk factors of osteoporosis of two groups of osteoporotic women and ...

  20. Handling knowledge on osteoporosis - a qualitative study

    DEFF Research Database (Denmark)

    Nielsen, Dorthe; Huniche, Lotte; Brixen, Kim

    2013-01-01

    Scand J Caring Sci; 2012 Handling knowledge on osteoporosis - a qualitative study The aim of this qualitative study was to increase understanding of the importance of osteoporosis information and knowledge for patients' ways of handling osteoporosis in their everyday lives. Interviews were...

  1. 34. annual conference Ontario Petroleum Institute

    International Nuclear Information System (INIS)

    1995-01-01

    A total of 18 papers, dealing with a variety of issues relevant to the petroleum industry, such as marketing strategies, feasibility studies and exploration technologies, were combined in this volume of proceedings of the 34th annual conference of the Ontario Petroleum Institute. Some of the papers presented case studies of hydrocarbon reserves in North America, along with their depositional histories. Oil yields and resource potential of fractured reservoirs was the subject of some presentations. Studies of cores from drilling sites and complete stratigraphic columns of some oil fields were also presented. (Papers are paged individually). refs., tabs., figs

  2. Ontario perspective on interregional markets

    International Nuclear Information System (INIS)

    Shalaby, A.

    2003-01-01

    On May 1, 2002, wholesale and retail electricity markets in Ontario were opened to competition. The industry structure has been completely unbundled into separate entities for power generation, distribution and transmission. There are currently 20 generators, 90 distributors and 4 transmitters in Ontario. Trade with neighbouring jurisdictions has increased and now accounts for 10 to 15 per cent of demand on summer peak days. Import/export capability with the United States (northeast and midwest) and other Canadian provinces (Quebec and Manitoba) is 4,000 to 6,000 MW. Ontario has not had new generation or transmission capacity in several years and the heat waves of summer 2002 resulted in a heavier power demand than forecasted. The province had to rely heavily on power imports resulting in high and volatile electricity prices. In response to customer complaints, the Ontario government froze retail rates and in a recent policy directive announced a public ownership policy for transmission with further consultation on improving supply competition in Ontario. FERC order 888 and the increased role of independent power producers has improved trading opportunities between Canada and the United States. The presentation highlighted recent trade trends and outlined the specific impact of the Standard Market Design on Canadian markets. It was noted that Ontario should work on ensuring power reliability, transmission planning, inter-regional coordination, and joint investments with neighbouring jurisdictions. 9 figs

  3. Osteoporosis among hospitalized patients with proximal femoral fractures in Assiut University Trauma Unit, Egypt.

    Science.gov (United States)

    Farouk, Osama; Mahran, Dalia G; Said, Hatem G; Alaa, Mohamed M; Eisa, Amr; Imam, Hisham; Said, G Z

    2017-12-01

    The study was done to investigate osteoporosis prevalence in 275 hip fracture admissions at the Trauma Unit of Assiut University Hospitals and associated factors, which are understudied in our locality. Prevalence was 74.9%. Female sex, older age, low body mass index, and fall on the ground were associated with osteoporosis. This study aims to identify osteoporosis prevalence in hip fracture admissions at the Trauma Unit of Assiut University Hospitals and to study the independent correlates of osteoporosis-related fracture. A prospective cross-sectional study was carried out in 275 hip fracture patients admitted to the Trauma Unit of Assiut University Hospitals from January through December 2014 of both sexes aged 50 years and older. Exclusion criteria were polytrauma, major accidents, and history of chronic conditions and long-term medication associated with osteoporosis risk increase and bilateral hip fractures. For every patient, weight, height, and bone mineral density by dual-energy x-ray absorptiometry (DEXA) were recorded. Tests of significance for non-parametric data were used. The questionnaire included sociodemographic characteristics, dietary habits, lifestyle factors such as smoking and physical activity, and female obstetric and gynecological factors. Mean age was 70.82 ± 11.02 SD; 51.6% were males and 8.4% were obese. Fall on ground was in 81.1% of fractures. Osteoporosis (femoral neck T score ≤ -2.5 SD) prevalence was 74.9%. By univariable analysis, significant correlates were female gender, older age, normal BMI, and fall on the ground. Milk and cheese daily intake was significantly associated with lower prevalence of osteoporosis. In a multivariable logistic regression model, female sex, older age, low BMI, and fall on the ground were associated with osteoporosis. Osteoporosis prevalence is high among hip fracture patients and associated with female sex, increase in age, low BMI, and fall on ground. Strategies to prevent osteoporosis are

  4. Proton pump inhibitors and osteoporosis

    DEFF Research Database (Denmark)

    Andersen, Bjarne Nesgaard; Johansen, Per Birger; Abrahamsen, Bo

    2016-01-01

    PURPOSE OF REVIEW: The purpose of the review is to provide an update on recent advances in the evidence based on proton pump inhibitors (PPI) as a possible cause of osteoporosis and osteoporotic fractures. This review focuses, in particular, on new studies published in the last 18 months and a di......PURPOSE OF REVIEW: The purpose of the review is to provide an update on recent advances in the evidence based on proton pump inhibitors (PPI) as a possible cause of osteoporosis and osteoporotic fractures. This review focuses, in particular, on new studies published in the last 18 months...... and a discussion of these findings and how this has influenced our understanding of this association, the clinical impact and the underlying pathophysiology. RECENT FINDINGS: New studies have further strengthened existing evidence linking use of PPIs to osteoporosis. Short-term use does not appear to pose a lower...... risk than long-term use. There is a continued lack of conclusive studies identifying the pathogenesis. Direct effects on calcium absorption or on osteoblast or osteoclast action cannot at present plausibly explain the mechanism. SUMMARY: The use of PPIs is a risk factor for development of osteoporosis...

  5. Quantitative imaging methods in osteoporosis.

    Science.gov (United States)

    Oei, Ling; Koromani, Fjorda; Rivadeneira, Fernando; Zillikens, M Carola; Oei, Edwin H G

    2016-12-01

    Osteoporosis is characterized by a decreased bone mass and quality resulting in an increased fracture risk. Quantitative imaging methods are critical in the diagnosis and follow-up of treatment effects in osteoporosis. Prior radiographic vertebral fractures and bone mineral density (BMD) as a quantitative parameter derived from dual-energy X-ray absorptiometry (DXA) are among the strongest known predictors of future osteoporotic fractures. Therefore, current clinical decision making relies heavily on accurate assessment of these imaging features. Further, novel quantitative techniques are being developed to appraise additional characteristics of osteoporosis including three-dimensional bone architecture with quantitative computed tomography (QCT). Dedicated high-resolution (HR) CT equipment is available to enhance image quality. At the other end of the spectrum, by utilizing post-processing techniques such as the trabecular bone score (TBS) information on three-dimensional architecture can be derived from DXA images. Further developments in magnetic resonance imaging (MRI) seem promising to not only capture bone micro-architecture but also characterize processes at the molecular level. This review provides an overview of various quantitative imaging techniques based on different radiological modalities utilized in clinical osteoporosis care and research.

  6. Osteoporosis in men: a review.

    Science.gov (United States)

    Adler, Robert A

    2014-01-01

    Osteoporosis and consequent fracture are not limited to postmenopausal women. There is increasing attention being paid to osteoporosis in older men. Men suffer osteoporotic fractures about 10 years later in life than women, but life expectancy is increasing faster in men than women. Thus, men are living long enough to fracture, and when they do the consequences are greater than in women, with men having about twice the 1-year fatality rate after hip fracture, compared to women. Men at high risk for fracture include those men who have already had a fragility fracture, men on oral glucocorticoids or those men being treated for prostate cancer with androgen deprivation therapy. Beyond these high risk men, there are many other risk factors and secondary causes of osteoporosis in men. Evaluation includes careful history and physical examination to reveal potential secondary causes, including many medications, a short list of laboratory tests, and bone mineral density testing by dual energy X-ray absorptiometry (DXA) of spine and hip. Recently, international organizations have advocated a single normative database for interpreting DXA testing in men and women. The consequences of this change need to be determined. There are several choices of therapy for osteoporosis in men, with most fracture reduction estimation based on studies in women.

  7. Impact of Euro-Canadian agrarian practices: in search of sustainable import-substitution strategies to enhance food security in subarctic Ontario, Canada.

    Science.gov (United States)

    Spiegelaar, Nicole F; Tsuji, Leonard J S

    2013-01-01

    In Canada, food insecurity exists among Aboriginal (Inuit, Metis and First Nations) people living in remote northern communities, in part, because of their reliance on the industrialized, import-based food system. Local food production as a substitute to imports would be an adaptive response, but enhancement of food security via food localization requires reflection on previous failings of conventional agricultural strategies so that informed decisions can be made. In light of potential reintroduction of local food production in remote First Nations communities, we investigated the cultural, social and ecological effects of a 20th century, Euro-Canadian agrarian settlement on the food system of a subarctic First Nation; this will act as the first step in developing a more sustainable local food program and enhancing food security in this community. To investigate the socio-cultural impacts of the Euro-Canadian agrarian initiative on the food system of Fort Albany First Nation, purposive, semi-directive interviews were conducted with elders and other knowledgeable community members. Interview data were placed into themes using inductive analyses. To determine the biophysical impact of the agrarian initiative, soil samples were taken from one site within the cultivated area and from one site in an undisturbed forest area. Soil properties associated with agricultural use and productivity were assessed. To compare the means of a given soil property between the sites, one-tailed t-tests were employed. Vegetative analysis was conducted in both sites to assess disturbance. According to the interviewees, prior to the agrarian initiative, First Nation families harvested wild game and fish, and gathered berries as well as other forms of vegetation for sustenance. With the introduction of the residential school and agrarian initiative, traditional food practices were deemed inadequate, families were forced to work and live in the settlement (becoming less reliant on

  8. The long-term outlook for nuclear capacity in Ontario

    International Nuclear Information System (INIS)

    Archinoff, G.H.

    1979-04-01

    This report derives three estimates of long-term nuclear growth in Ontario for use in strategy studies of alternate nuclear fuel cycles. The low and high estimates encompass the full range of possible long-term nuclear growth rates. The middle, or base growth, estimate represents the nuclear growth pattern which seems at the present time most likely to occur. For the base growth estimate, nuclear capacity in Ontario reaches 31 GWe in 2000, grows to 175 GWe by 2060, and then remains constant. For the high growth estimate, the capacity in 2000 is 33 GWe, and climbs continuously to 833 GWe by the year 2100. (auth)

  9. Effectiveness of a two-step population-based osteoporosis screening program using FRAX

    DEFF Research Database (Denmark)

    Rubin, K H; Rothmann, M J; Holmberg, T

    2018-01-01

    The Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study investigated the effectiveness of a two-step screening program for osteoporosis in women. We found no overall reduction in fractures from systematic screening compared to the current case-finding strategy. The group of moderate......- to high-risk women, who accepted the invitation to DXA, seemed to benefit from the program. INTRODUCTION: The purpose of the ROSE study was to investigate the effectiveness of a two-step population-based osteoporosis screening program using the Fracture Risk Assessment Tool (FRAX) derived from a self......-administered questionnaire to select women for DXA scan. After the scanning, standard osteoporosis management according to Danish national guidelines was followed. METHODS: Participants were randomized to either screening or control group, and randomization was stratified according to age and area of residence. Inclusion...

  10. Ontario freight movement study

    International Nuclear Information System (INIS)

    Anon.

    1995-11-01

    The freight (cargo) transportation sector accounts for a major use of fossil fuels and contributes significantly to greenhouse gas emissions. A study was conducted to estimate and forecast emissions from transportation in Ontario, by mode, over the next 15 years, and to examine ways in which those emissions could be reduced. Published data of freight transportation industries was used to examine the fuel consumption characteristics of each mode, followed by a review of emission rates. It was determined that truck transportation accounts for most CO 2 emissions (about 70%). Rail follows with 21% and the marine and air modes contribute relatively small shares (6% and 2%). New intermodal technologies being introduced by the railways were discussed. They have been designed to make intermodal transport more accessible to a wider segment of the freight market. A recommendation was made which would require all truck shipments over 500 km, accounting for fully one half of truck tonne-km, to have their line-haul component diverted to this new more fuel-efficient mode (i.e., from truck to rail). refs., tabs., figs

  11. The Ontario Psychosocial Oncology Framework: a quality improvement tool.

    Science.gov (United States)

    Li, Madeline; Green, Esther

    2013-05-01

    To overview the newly developed Psychosocial Health Care for Cancer Patients and Their Families: A Framework to Guide Practice in Ontario and Guideline Recommendations in the context of Canadian psychosocial oncology care and propose strategies for guideline uptake and implementation. Recommendations from the 2008 Institute of Medicine standard Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs were adapted into the Ontario Psychosocial Oncology (PSO) Framework. Existing practice guidelines developed by the Canadian Partnership against Cancer and Cancer Care Ontario and standards developed by the Canadian Association of Psychosocial Oncology are supporting resources for adopting a quality improvement (QI) approach to the implementation of the framework in Ontario. The developed PSO Framework, including 31 specific actionable recommendations, is intended to improve the quality of comprehensive cancer care at both the provider and system levels. Important QI change management processes are described as Educate - raising awareness among medical teams of the significance of psychosocial needs of patients, Evidence - developing a research evidence base for patient care benefits from psychosocial interventions, and Electronics - using technology to collect patient reported outcomes of both physical and emotional symptoms. The Ontario PSO Framework is unique and valuable in providing actionable recommendations that can be implemented through QI processes. Overall, the result will be improved psychosocial health care for the cancer population. Copyright © 2012 John Wiley & Sons, Ltd.

  12. Osteopenia and osteoporosis in people living with HIV: multiprofessional approach.

    Science.gov (United States)

    Lima, Ana Lucia Lei Munhoz; de Oliveira, Priscila Rosalba D; Plapler, Perola Grimberg; Marcolino, Flora Maria D Andrea; de Souza Meirelles, Eduardo; Sugawara, André; Gobbi, Riccardo Gomes; Dos Santos, Alexandre Leme Godoy; Camanho, Gilberto Luis

    2011-01-01

    Increasing bone mineralization abnormalities observed among people living with HIV (PLWHIV) result from various factors relating to the host, the virus, and the antiretrovirals used. Today, HIV infection is considered to be a risk factor for bone mineralization disorders. The test most recommended for diagnosing osteoporosis is measurement of bone mineral density by means of dual energy X-ray absorptiometry at two sites. Osteoporosis treatment has the aims of bone mass improvement and fracture control. A combination of calcium and vitamin D supplementation may reduce the risk of fractures. Antiresorptive drugs act by blocking osteoclastic activity and reducing bone remodeling. On the other hand, bone-forming drugs stimulate osteoblastogenesis, thereby stimulating the formation of bone matrix. Mixed-action medications are those that are capable of both stimulating bone formation and inhibiting reabsorption. Antiresorptive drugs form the group of medications with the greatest quantity of scientific evidence confirming their efficacy in osteoporosis treatment. Physical activity is a health promotion strategy for the general population, but only preliminary data on its real value and benefit among PLWHIV are available, especially in relation to osteoporosis.

  13. Osteoporosis: the current status of mesenchymal stem cell-based therapy.

    Science.gov (United States)

    Phetfong, Jitrada; Sanvoranart, Tanwarat; Nartprayut, Kuneerat; Nimsanor, Natakarn; Seenprachawong, Kanokwan; Prachayasittikul, Virapong; Supokawej, Aungkura

    2016-01-01

    Osteoporosis, or bone loss, is a progressive, systemic skeletal disease that affects millions of people worldwide. Osteoporosis is generally age related, and it is underdiagnosed because it remains asymptomatic for several years until the development of fractures that confine daily life activities, particularly in elderly people. Most patients with osteoporotic fractures become bedridden and are in a life-threatening state. The consequences of fracture can be devastating, leading to substantial morbidity and mortality of the patients. The normal physiologic process of bone remodeling involves a balance between bone resorption and bone formation during early adulthood. In osteoporosis, this process becomes imbalanced, resulting in gradual losses of bone mass and density due to enhanced bone resorption and/or inadequate bone formation. Several growth factors underlying age-related osteoporosis and their signaling pathways have been identified, such as osteoprotegerin (OPG)/receptor activator of nuclear factor B (RANK)/RANK ligand (RANKL), bone morphogenetic protein (BMP), wingless-type MMTV integration site family (Wnt) proteins and signaling through parathyroid hormone receptors. In addition, the pathogenesis of osteoporosis has been connected to genetics. The current treatment of osteoporosis predominantly consists of antiresorptive and anabolic agents; however, the serious adverse effects of using these drugs are of concern. Cell-based replacement therapy via the use of mesenchymal stem cells (MSCs) may become one of the strategies for osteoporosis treatment in the future.

  14. HYPERTENSION AND OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN

    Directory of Open Access Journals (Sweden)

    Marina Rašić Popović

    2009-04-01

    % (14 to 25%.Osteoporosis and hypertension are two mass noninfectious diseases, the incidence of which increases with aging of the population. Early menopause, estrogen deficit, age, smoking and physical inactivity are important risk factors. Based on these results, it is appropriate to consider preventive strategy for early detection and management of these diseases.

  15. SALIVA SEBAGAI UJI SARING OSTEOPOROSIS

    Directory of Open Access Journals (Sweden)

    Niniarty Z. Djamal

    2015-07-01

    Full Text Available Osteoporosis is a metabolic bone disease, and is characterized by low bone mass and microstructure deterioration of the bone, which leads to increased risk of fracture. Biomarker of bone metabolism can be seen as beginning of bone loss and first detection before imbalanced bone turnover comes. Biomarker of bone formation as serum bone alkaline fosfatase, osteocalcin (OC, procollagen type I, and biomarker of bone resorption as urine pyridinoline (Pyd and deoxypyridinoline (Dpd crosslinks, hydroxyprolin. The simultaneous examination of serum OC and urine Pyd or Dpd as a very good screening test for determination of bone imbalanced at the moment of the menopausal or the beginning of the pasca menopausal. Saliva as a potential diagnostic fluid for the assessment of osteoporosis biomarker concentrations. The study found elevated three classic warning signs for osteopororsis os OC, Dpd and 116 in the saliva of sheep without ovaries, which were similar to the levels of signs found in their blood and urine. Expectations, that the test may become available within five years and one day the test may be able to be performed at home like pregnancy test. Osteoporosis biomarker in saliva suggested detected of bone mass density easier. Beside that can be used as a method of early diagnostic and as a monitor therapy that as salinity of the examinations of bone mass on radiology.

  16. Relationship of obesity with osteoporosis

    Science.gov (United States)

    Zhao, Lan-Juan; Liu, Yong-Jun; Liu, Peng-Yuan; Hamilton, James; Recker, Robert R.; Deng, Hong-Wen

    2007-01-01

    Context The relationship between obesity and osteoporosis has been widely studied, and epidemiological evidence shows that obesity is correlated with increased bone mass. Previous analyses, however, did not control for the mechanical loading effects of total body weight on bone mass and may have generated a confounded or even biased relationship between obesity and osteoporosis. Objective To re-evaluate the relationship between obesity and osteoporosis by accounting for the mechanical loading effects of total body weight on bone mass. Methods We measured whole body fat mass, lean mass, percentage fat mass (PFM), body mass index (BMI), and bone mass in two large samples of different ethnicity: 1,988 unrelated Chinese subjects and 4,489 Caucasian subjects from 512 pedigrees. We first evaluated the Pearson correlations among different phenotypes. We then dissected the phenotypic correlations into genetic and environmental components, with bone mass unadjusted, or adjusted, for body weight. This allowed us to compare the results with and without controlling for mechanical loading effects of body weight on bone mass. Results In both Chinese and Caucasians, when the mechanical loading effect of body weight on bone mass was adjusted for, the phenotypic correlation (including its genetic and environmental components) between fat mass (or PFM) and bone mass was negative. Further multivariate analyses in subjects stratified by body weight confirmed the inverse relationship between bone mass and fat mass, after mechanical loading effects due to total body weight was controlled. Conclusions Increasing fat mass may not have a beneficial effect on bone mass. PMID:17299077

  17. Time trends in osteoporosis risk factor profiles

    DEFF Research Database (Denmark)

    Holm, Jakob Præst; Hyldstrup, Lars; Jensen, Jens-Erik Beck

    2016-01-01

    The aim of this article was to identify prevalent osteoporosis risk factors, medications and comorbidities associated with bone mineral density (BMD). Furthermore to evaluate changes in risk factor profiles over 12 years. 6285 women consecutively referred to an osteoporosis specialist clinic were...... was established in a real-life setting. The prevalence of osteoporosis and proportion of patient's having comorbidity's associated with osteoporosis were increasing during the inclusion period (start 23.8 %, end 29.7 %). Increasing age (OR = 1.05), current smoking (OR = 1.18), estrogen deficiency (OR = 1.......7), hyperthyroidism (OR = 1.5), previous major osteoporotic fracture (OR = 1.7), former osteoporosis treatment (OR = 3.5), higher BMI (OR = 0.87), use of calcium supplementation (OR = 1.2), high exercise level (OR = 0.7), and use of thiazide diuretics (OR = 0.7) were identified as predictors of osteoporosis by DXA...

  18. Osteopenia and osteoporosis in people living with HIV: multiprofessional approach

    Directory of Open Access Journals (Sweden)

    Lima AL

    2011-12-01

    Full Text Available Ana Lucia Lei Munhoz Lima, Priscila Rosalba D de Oliveira, Perola Grimberg Plapler, Flora Maria D Andrea Marcolino, Eduardo de Souza Meirelles, André Sugawara, Riccardo Gomes Gobbi, Alexandre Leme Godoy dos Santos , Gilberto Luis CamanhoInstitute of Orthopedics and Traumatology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, BrazilAbstract: Increasing bone mineralization abnormalities observed among people living with HIV (PLWHIV result from various factors relating to the host, the virus, and the antiretrovirals used. Today, HIV infection is considered to be a risk factor for bone mineralization disorders. The test most recommended for diagnosing osteoporosis is measurement of bone mineral density by means of dual energy X-ray absorptiometry at two sites. Osteoporosis treatment has the aims of bone mass improvement and fracture control. A combination of calcium and vitamin D supplementation may reduce the risk of fractures. Antiresorptive drugs act by blocking osteoclastic activity and reducing bone remodeling. On the other hand, bone-forming drugs stimulate osteoblastogenesis, thereby stimulating the formation of bone matrix. Mixed-action medications are those that are capable of both stimulating bone formation and inhibiting reabsorption. Antiresorptive drugs form the group of medications with the greatest quantity of scientific evidence confirming their efficacy in osteoporosis treatment. Physical activity is a health promotion strategy for the general population, but only preliminary data on its real value and benefit among PLWHIV are available, especially in relation to osteoporosis.Keywords: osteoporosis, HIV/AIDS, diagnosis, treatment, exercise

  19. Economic Consequences and Potentially Preventable Costs Related to Osteoporosis in the Netherlands.

    Science.gov (United States)

    Dunnewind, Tom; Dvortsin, Evgeni P; Smeets, Hugo M; Konijn, Rob M; Bos, Jens H J; de Boer, Pieter T; van den Bergh, Joop P; Postma, Maarten J

    2017-06-01

    Osteoporosis often does not involve symptoms, and so the actual number of patients with osteoporosis is higher than the number of diagnosed individuals. This underdiagnosis results in a treatment gap. To estimate the total health care resource use and costs related to osteoporosis in the Netherlands, explicitly including fractures, and to estimate the proportion of fracture costs that are linked to the treatment gap and might therefore be potentially preventable; to also formulate, on the basis of these findings, strategies to optimize osteoporosis care and treatment and reduce its related costs. In this retrospective study, data of the Achmea Health Database representing 4.2 million Dutch inhabitants were used to investigate the economic consequence of osteoporosis in the Netherlands in 2010. Specific cohorts were created to identify osteoporosis-related fractures and their costs. Besides, costs of pharmaceutical treatment regarding osteoporosis were included. Using data from the literature, the treatment gap was estimated. Sensitivity analysis was performed on the base-case results. A total of 108,013 individuals with a history of fractures were included in this study. In this population, 59,193 patients were using anti-osteoporotic medication and 86,776 patients were using preventive supplements. A total number of 3,039 osteoporosis-related fractures occurred. The estimated total costs were €465 million. On the basis of data presented in the literature, the treatment gap in our study population was estimated to vary from 60% to 72%. The estimated total costs corrected for treatment gap were €1.15 to €1.64 billion. These results indicate room for improvement in the health care policy against osteoporosis. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  20. Ontario Hydro looks at security

    International Nuclear Information System (INIS)

    Green, B.J.; Kee, B.

    1995-01-01

    Ontario Hydro operates 20 CANDU reactors on three different sites. Since 1984, a review of security arrangements on all the sites has taken place on a five-yearly basis. The review process for 1995 is outlined. The three objectives were as follows: to assess current security threats and risks to the stations; to assess the adequacy of the existing programme to protect against current threats; by comparing the security programme against those of comparable entities to establish benchmarks for good practice as a basis for improvements at Ontario Hydro. Valuable insights gained through the review are listed. These could be useful to other utilities. (UK)

  1. Transmission system planning in Ontario

    Energy Technology Data Exchange (ETDEWEB)

    Barrie, D; Macedo, F X; Mcconnach, J S [Ontario Hydro, Toronto, ON (Canada)

    1994-12-31

    In recent years, new and modified approaches to planning the large transmission system that serves the province of Ontario, Canada, have been necessary to accommodate the rapidly changing planning environment including slower uncertain growth, ageing of facilities, integration of demand side management and non utility generation options, increased competitiveness, increased financial stresses and affordable constraints. This paper describes some of the new and modified approaches and tools that have been adopted or are being developed by Ontario Hydro to cope with this changing environment. (author) 9 refs., 4 figs.

  2. "Osteoporosis and orthopods" incidences of osteoporosis in distal radius fracture from low energy trauma.

    LENUS (Irish Health Repository)

    Bahari, Syah

    2007-07-01

    Fracture of the distal radius from low energy trauma is a common presentation to orthopaedic trauma services. This fragility type fracture is associated with underlying osteoporosis. Osteoporosis is a \\'silent disease\\' where fragility fracture is a common presentation. Orthopaedic surgeons may be the only physician that these patients encounter. We found a high percentage of female patients who sustained a fragility fracture of the distal radius have an underlying osteoporosis. Further management of osteoporosis is important to prevent future fragility fractures.

  3. Skeletal Aging and Osteoporosis Biomechanics and Mechanobiology

    CERN Document Server

    2013-01-01

    The focus of this book is on mechanical aspects of skeletal fragility related to aging and osteoporosis. Topics include: Age-related changes in trabecular structure and strength; age-related changes in cortical material properties; age-related changes in whole-bone structure; predicting bone strength and fracture risk using image-based methods and finite element analysis; animal models of osteoporosis and aging; age-related changes in skeletal mechano responsiveness; exercise and physical interventions for osteoporosis.

  4. The Value of Laboratory Tests in Diagnosing Secondary Osteoporosis at a Fracture and Osteoporosis Outpatient Clinic

    NARCIS (Netherlands)

    de Klerk, Gijs; Hegeman, J. Han; van der Velde, Detlef; van der Palen, Jacobus Adrianus Maria; ten Duis, Henk J.

    2013-01-01

    Background: As more and more patients meeting the criteria for osteoporosis are referred to a fracture and osteoporosis outpatient clinic (FO clinic), the laboratory costs to screen for secondary osteoporosis also increases. This study was conducted to determine the value of screening on underlying

  5. Established Osteoporosis and Gaps in the Management: Review ...

    African Journals Online (AJOL)

    Background: International osteoporosis foundation described severe or established osteoporosis as an osteoporotic individual with a fragility fracture. Orthopaedic surgeons frequently manage fractures, but we believe that large gaps are prevalent in the medical management of osteoporosis after fractures are fixed.

  6. Ontario Hydro annual report 1986

    Energy Technology Data Exchange (ETDEWEB)

    1987-04-01

    Ontario Hydro`s annual report of the financial position and activities for the year 1986 consists of their financial highlights; corporate profile; customer service and satisfaction; message from Chairman; message from President; 1986 in review; financial section; management report; five-year summary of financial statistics; and comparative statistics.

  7. Ontario Hydro annual report 1986

    International Nuclear Information System (INIS)

    1987-04-01

    Ontario Hydro's annual report of the financial position and activities for the year 1986 consists of their financial highlights; corporate profile; customer service and satisfaction; message from Chairman; message from President; 1986 in review; financial section; management report; five-year summary of financial statistics; and comparative statistics

  8. [Ontario Hydro]. Corporate performance report, 1994

    International Nuclear Information System (INIS)

    1995-01-01

    Summarizes Ontario Hydro's corporate performance for the year, with actual results being compared against planned values. Also includes additional indicators that illustrate noteworthy trends in corporate performance. Corporate results are reported under the new organizational structure implemented in 1993, beginning with overall results in such areas as customer service, environmental stewardship, human resources, and finance. This is followed by reports from the Generation Business Group, Customer Services Group, Corporate Business Group, General Counsel and Secretary, Ontario Hydro Audit, Strategic Planning, Environment and Communication Group, and Ontario Hydro enterprises (Ontario Hydro Technologies, Ontario Hydro International). The appendix includes summary financial statements

  9. Ontario Energy Corporation annual report 1981. [Monograph

    Energy Technology Data Exchange (ETDEWEB)

    1981-01-01

    The Ontario Energy Corporation's mission of providing leadership and investment capital for selected energy ventures brought its total participation in projects from $16.4 million to $669 million, and its total assets increased from $44.4 million to $693 million during the year. The annual report review major operations with Ontario Energy Resources Ltd., Onexco Ltd., Ontario Alternate Energy Ltd., Ontario Power Share Ltd., and Ontario Energy in Transportation Ltd. The financial report includes a balance sheet, income and retained earnings statement, and a summary of financial changes during the reporting period. 1 figure, 4 tables. (DCK)

  10. General and oral aspects of osteoporosis: a review

    DEFF Research Database (Denmark)

    Wowern von, N.

    2001-01-01

    Age, bone mineral content, bone loss, dentures, implants, mandible/maxilla, osteoporosis, periodontitis......Age, bone mineral content, bone loss, dentures, implants, mandible/maxilla, osteoporosis, periodontitis...

  11. A knowledge translation tool improved osteoporosis disease management in primary care: an interrupted time series analysis.

    Science.gov (United States)

    Kastner, Monika; Sawka, Anna M; Hamid, Jemila; Chen, Maggie; Thorpe, Kevin; Chignell, Mark; Ewusie, Joycelyne; Marquez, Christine; Newton, David; Straus, Sharon E

    2014-09-25

    Osteoporosis affects over 200 million people worldwide at a high cost to healthcare systems, yet gaps in management still exist. In response, we developed a multi-component osteoporosis knowledge translation (Op-KT) tool involving a patient-initiated risk assessment questionnaire (RAQ), which generates individualized best practice recommendations for physicians and customized education for patients at the point of care. The objective of this study was to evaluate the effectiveness of the Op-KT tool for appropriate disease management by physicians. The Op-KT tool was evaluated using an interrupted time series design. This involved multiple assessments of the outcomes 12 months before (baseline) and 12 months after tool implementation (52 data points in total). Inclusion criteria were family physicians and their patients at risk for osteoporosis (women aged ≥ 50 years, men aged ≥ 65 years). Primary outcomes were the initiation of appropriate osteoporosis screening and treatment. Analyses included segmented linear regression modeling and analysis of variance. The Op-KT tool was implemented in three family practices in Ontario, Canada representing 5 family physicians with 2840 age eligible patients (mean age 67 years; 76% women). Time series regression models showed an overall increase from baseline in the initiation of screening (3.4%; P management addressed by their physician. Study limitations included the inherent susceptibility of our design compared with a randomized trial. The multicomponent Op-KT tool significantly increased osteoporosis investigations in three family practices, and highlights its potential to facilitate patient self-management. Next steps include wider implementation and evaluation of the tool in primary care.

  12. Clinical impact of recent genetic discoveries in osteoporosis

    Directory of Open Access Journals (Sweden)

    Mitchell BD

    2013-10-01

    Full Text Available Braxton D Mitchell, Elizabeth A StreetenDepartment of Medicine and Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, and Geriatric Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, MD, USAAbstract: Osteoporotic fracture carries an enormous public health burden in terms of mortality and morbidity. Current approaches to identify individuals at high risk for fracture are based on assessment of bone mineral density and presence of other osteoporosis risk factors. Bone mineral density and susceptibility to osteoporotic fractures are highly heritable, and over 60 loci have been robustly associated with one or both traits through genome-wide association studies carried out over the past 7 years. In this review, we discuss opportunities and challenges for incorporating these genetic discoveries into strategies to prevent osteoporotic fracture and translating new insights obtained from these discoveries into development of new therapeutic targets.Keywords: bone mineral density, genome-wide association studies, osteoporosis, prediction, fracture, genetics

  13. Osteoporosis and years since menopause

    International Nuclear Information System (INIS)

    Ide, Saburo; Hirota, Yoshio; Hotokebuchi, Takao; Takasugi, Shin-ichiro; Sugioka, Yoichi; Hayabuchi, Hitomi

    1999-01-01

    In Fukuoka Prefecture, in south-western Japan, a regional screening program for osteoporosis was conducted from 1994 to 1995. The screening level in the bone mineral density (BMD) at the distal non-dominant radius was equal to or less than two standard deviations below age-specific mean (≤ -2.0 SD). In 1177 examinees with natural menopause (mean age: 61.4, range: 42-88), 56 of those who were screened were subsequently radiologically confirmed by orthopedic specialists to have osteoporosis (case group). They were then compared with 802 normal BMD (≥ -1.0 SD) women (reference group) with their lifestyle and reproductive characteristics. The adjusted odds ratio (OR) and its 95% confidence interval (CI) were calculated using a logistic regression model. A significant increase in the ORs for osteoporosis based on the number of years since menopause was observed for 7-13 years since menopause (OR=2.3; 95% CI: 1.0-5.4) compared with <7 years, however, no increasing trend in risk was evident in 14+ years since menopause (OR=1.4; 95% CI: 0.4-5.1). Thus, the elevated risk continued up to around 10 years since menopause. These findings are consistent with previous studies that reported an alternation in the calcium metabolism and bone loss related to the length of time after menopause. Both the childhood and current milk consumption were also associated with a decreased risk: ORs were 0.4 (95% CI: 0.2-0.9) and 0.5 (95% CI: 0.3-1.0), respectively

  14. Ontario electricity rates and industrial competitiveness

    International Nuclear Information System (INIS)

    2006-01-01

    Industrial electricity prices in Ontario rose significantly after the opening of the competitive Ontario electricity market in 2002, thereby widening the gap between industrial electricity prices in Ontario and those in other Canadian provinces. Navigant Consulting Ltd. conducted this study at the request of the Association of Major Power Consumers in Ontario (AMPCO) to research and compare current and historical electricity prices in Ontario and other jurisdictions in North America. The study provided an independent analysis of how industrial electricity prices in Ontario compare to those in other jurisdiction in which AMPCO members operate. It also formed the basis for comparing the impacts of electricity policy on the economic competitiveness of major power consumers in Ontario. The relative electricity intensity in the United States, Ontario and other Canadian provinces was reviewed for specific industries, including forest products, steel manufacturing, petroleum refining, chemical manufacturing and cement manufacturing. Publicly available aggregate data from Statistics Canada and the United States Bureau of the Census was then used to compare average electricity prices for industrial customers in Ontario. The data confirmed that Ontario has experienced a decline in its competitive price advantage in industrial electricity. Delivered industrial electricity prices in Ontario have increased by more than 60 per cent since 2001. Industrial electricity prices in Ontario rose above those in Quebec, Manitoba, British Columbia and New Brunswick. In addition, industrial electricity prices in Ontario rose above those in competing states such as Ohio and Illinois, in part due to the increase in the value of the Canadian dollar. It was concluded that the price increase may lead to a greater decline in economic output in Ontario compared to competing jurisdictions. 2 tabs., 14 figs., 1 appendix

  15. Osteoporosis in chronic obstructive pulmonary disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Niklas Rye; Schwarz, Peter

    2008-01-01

    The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence.......The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence....

  16. Epidemiological association between osteoporosis and combined ...

    African Journals Online (AJOL)

    ... higher dietary calcium intake was negatively associated with osteoporosis. Conclusions: Based on these findings, it can be concluded that the combined lifetime use of both snuff and cigarettes may increase the odds of developing osteoporosis among women who are 40 years and older. Key words: Cigarette, nicotine, ...

  17. SCOPE: a scorecard for osteoporosis in Europe

    NARCIS (Netherlands)

    Kanis, J.A.; Borgstrom, F.; Compston, J.; Dreinhofer, K.; Nolte, E.; Jonsson, L.; Lems, W.F.; McCloskey, E.V.; Rizzoli, R.; Stenmark, J.

    2013-01-01

    The scorecard summarises key indicators of the burden of osteoporosis and its management in each of the member states of the European Union. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. Introduction: The scorecard for

  18. 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada

    Science.gov (United States)

    Brown, Jacques P.; Josse, Robert G.

    2002-01-01

    Objective To revise and expand the 1996 Osteoporosis Society of Canada clinical practice guidelines for the management of osteoporosis, incorporating recent advances in diagnosis, prevention and management of osteoporosis, and to identify and assess the evidence supporting the recommendations. Options All aspects of osteoporosis care and its fracture complications — including classification, diagnosis, management and methods for screening, as well as prevention and reducing fracture risk — were reviewed, revised as required and expressed as a set of recommendations. Outcomes Strategies for identifying and evaluating those at high risk; the use of bone mineral density and biochemical markers in diagnosis and assessing response to management; recommendations regarding nutrition and physical activity; and the selection of pharmacologic therapy for the prevention and management of osteoporosis in men and women and for osteoporosis resulting from glucocorticoid treatment. Evidence All recommendations were developed using a justifiable and reproducible process involving an explicit method for the evaluation and citation of supporting evidence. Values All recommendations were reviewed by members of the Scientific Advisory Council of the Osteoporosis Society of Canada, an expert steering committee and others, including family physicians, dietitians, therapists and representatives of various medical specialties involved in osteoporosis care (geriatric medicine, rheumatology, endocrinology, obstetrics and gynecology, nephrology, radiology) as well as methodologists from across Canada. Benefits, harm and costs Earlier diagnosis and prevention of fractures should decrease the medical, social and economic burdens of this disease. Recommendations This document outlines detailed recommendations pertaining to all aspects of osteoporosis. Strategies for identifying those at increased risk (i.e., those with at least one major or 2 minor risk factors) and screening with central

  19. Feminism and women's health professions in Ontario.

    Science.gov (United States)

    Adams, Tracey L; Bourgeault, Ivy Lynn

    2003-01-01

    Historically, prevailing gender ideologies were an important element in both the exclusionary strategies employed by male occupational groups and the countervailing responses by female groups. The way in which evolving gender ideologies, and feminism in particular, influence the continuing struggle for greater status and recognition by female professions, however, remains to be fully explored. In this paper, we examine the impact and the role of feminism and feminist ideologies within three female professional projects: nursing, dental hygiene and midwifery in Ontario. We argue that feminism provides an ideology of opposition that enables leaders in these professions to battle against professional inequalities by laying bare the gender inequalities that underlie them. Framing their struggles in feminist terms, female professions also seek recognition for the uniquely female contribution they make to the health care division of labour. At the same time, there exists a tension between ideals of feminism and ideals of professionalism, that has the potential to undermine female professional projects.

  20. Ontario freight movement study: component two

    International Nuclear Information System (INIS)

    Hackston, D.; Lake, R.; Schwier, C.; Tardif, L.P.; English, G.; Bunting, M.

    1995-11-01

    The freight (cargo) transportation sector accounts for a major use of fossil fuels and contributes significantly to greenhouse gas emissions. A study was conducted to assess the prospects, in terms of CO 2 emission reduction, of alternatives to present freight distribution, especially alternatives involving the use of rail instead of truck. Statistical data for Ontario freight transportation were analyzed for fuel consumption, CO 2 emission and cost consequences. Railway fuel consumption was calculated for detailed routing descriptions using a model that computed route and service specific fuel use. The information was compared directly with truck fuel consumption. It was determined that shippers who needed quick, accurately timed shipments preferred trucking over rail, while price conscious shippers, or those with heavy loading commodities preferred rail. An important goal of the study was to identify the enormity of the challenges involved, and clarify the potential tradeoffs by showing different strategies, with respect to CO 2 reduction and related economic impacts. refs., tabs., figs

  1. Osteoporosis in pregnancy: more than postural backache.

    Science.gov (United States)

    Topping, J; Black, A J; Farquharson, R G; Fraser, W D

    1998-01-01

    Though uncommon, osteoporosis can occur in pregnancy or shortly after delivery. The most common feature is back pain, often severely disabling. Suspect osteoporosis if pain of sudden onset in the upper lumbar or thoracic spine is not relieved by simple analgesia, or if there is a noticeable loss of height. X-rays reveal low bone density and fractures of the vertebrae. 70% of cases occur in first pregnancies. Recurrence is unusual. Most cases resolve spontaneously; a minority cause disability lasting months or years. If osteoporosis is diagnosed, breast feeding should be discouraged because of its effect on bone mineral density. Anyone who has had osteoporosis of pregnancy is at risk of postmenopausal osteoporosis and should take medical advice.

  2. Balance control in elderly people with osteoporosis

    Directory of Open Access Journals (Sweden)

    Wei-Li Hsu

    2014-06-01

    Full Text Available Osteoporosis is a prevalent health concern among older adults and is associated with an increased risk of falls that incur fracture, injury, or mortality. Identifying the risk factors of falls within this population is essential for the development of effective regimes for fall prevention. Studies have shown that muscle quality and good posture alignments are critical for balance control in elderly individuals. People with osteoporosis often have muscle weakness and increased spine kyphosis leading to vertebral fractures and poor balance control, or even falls. Therefore, improving muscle quality, strengthening weak muscles, and correcting postural alignment are essential elements for the prevention of falls and fractures in older adults with osteoporosis. This review reports the necessary information regarding the critical factors of balance control in older adults with osteoporosis, as well as testing the clinical innovations of exercise training to improve the long-term prognosis of osteoporosis in this vulnerable population.

  3. New insights into the tonifying kidney-yin herbs and formulas for the treatment of osteoporosis.

    Science.gov (United States)

    He, Jian-Bo; Chen, Mei-Hui; Lin, Ding-Kun

    2017-12-01

    Osteoporosis is characterized by an increasing osseous fragility and fracture resulting from the low mass and deteriorated microarchitecture in the bone tissue. The hormone replacement therapy and alendronate were frequently used to treat osteoporosis as the primary therapeutic strategy, but their adverse effects have severely limited their extensive clinical application, therefore, it is urgent to develop alternative or complementary therapeutic agents for anti-osteoporosis. Interestingly, with more people focusing on the complementary and alternative medicine, traditional Chinese herbs and formulas are being gradually recognized as safe and effective agents in the treatment of osteoporosis. In particular, a notable trend is that increasing studies are making efforts to clarify the anti-osteoporotic effects and mechanism of the tonifying kidney-yin herbs and formulas, a category of agents identified as effective therapy. Therefore, the purpose of this study is to comprehensively review the tonifying kidney-yin herbs and formulas that have been reported in the treatment of osteoporosis as well as how the agents play their roles in detail. This current study not only will advance our understanding of the actions of tonifying kidney-yin herbs and formulas, but also provide new evidence for the clinic use of the tonifying kidney-yin herbs and formulas in the treatment of osteoporosis.

  4. New anabolic therapies in osteoporosis.

    Science.gov (United States)

    Rubin, Mishaela R; Bilezikian, John P

    2003-03-01

    Anabolic agents represent an important new advance in the therapy of osteoporosis. Their potential might be substantially greater than the anti-resorptives. Because the anti-resorptives and anabolic agents work by completely distinct mechanisms of action, it is possible that the combination of agents could be significantly more potent than either agent alone. Recent evidence suggests that a plateau in BMD might occur after prolonged exposure to PTH. Anti-resorptive therapy during or after anabolic therapy might prevent this skeletal adaptation. Protocols to consider anabolic agents as intermittent recycling therapy would be of interest. Of all the anabolics, PTH is the most promising. However, there are unanswered questions about PTH. More studies are needed to document an anabolic effect on cortical bone. More large-scale studies are needed to further determine the reduction in nonvertebral fractures with PTH, especially at the hip. In the future, PTH is likely to be modified for easier and more targeted delivery. Oral or transdermal delivery systems may become available. Recently, Gowen et al have described an oral calcilytic molecule that antagonizes the parathyroid cell calcium receptor, thus stimulating the endogenous release of PTH. This approach could represent a novel endogenous delivery system for intermittent PTH administration. Rising expectations that anabolic therapies for osteoporosis will soon play a major role in treating this disease are likely to fuel further studies and the development of even more novel approaches to therapy.

  5. Wastewater quality control at Sarnia (Ontario, Canada) petrochemical industries

    Energy Technology Data Exchange (ETDEWEB)

    Vianna, Arlinda C. [Servico Nacional de Aprendizagem Industrial (SENAI), Salvador, BA (Brazil); Souza, Eliane S.; Himmelman, William [Lambton College, Sarnia, ON (Canada)

    1993-12-31

    Ontario industries are required by law to meet strict regulations under the provinces under MISA initiative (Municipal-Industrial Strategy for Abatement). The petroleum-petrochemical area was selected as a leader in the development of new environmental objectives, and monitoring and training programs. Sarnia has become a world leader in industrial environmental control systems and the approach toward zero emissions. 4 refs., 6 figs., 2 tabs.

  6. Wastewater quality control at Sarnia (Ontario, Canada) petrochemical industries

    Energy Technology Data Exchange (ETDEWEB)

    Vianna, Arlinda C [Servico Nacional de Aprendizagem Industrial (SENAI), Salvador, BA (Brazil); Souza, Eliane S; Himmelman, William [Lambton College, Sarnia, ON (Canada)

    1994-12-31

    Ontario industries are required by law to meet strict regulations under the provinces under MISA initiative (Municipal-Industrial Strategy for Abatement). The petroleum-petrochemical area was selected as a leader in the development of new environmental objectives, and monitoring and training programs. Sarnia has become a world leader in industrial environmental control systems and the approach toward zero emissions. 4 refs., 6 figs., 2 tabs.

  7. Ontario Hydro Research Division, 1980

    International Nuclear Information System (INIS)

    The work of the Research Division of Ontario Hydro provides technical and scientific support for the engineering and operation of a power system that includes hydraulic, fossil-fired, and nuclear generation. It also relates to the transmission and distribution of electricity and to the need to help customers use electricity with safety and economy. Among the examples of projects given are qualification of CANDU heat transport system components, pressure tube replacement, steam generator integrity, testing for earthquake resistance, and radioactive waste disposal

  8. Transforming Ontario's Power Generation Company

    International Nuclear Information System (INIS)

    Manley, J.; Epp, J.; Godsoe, P.C.

    2004-01-01

    The OPG Review Committee was formed by the Ontario Ministry of Energy to provide recommendations and advice on the future role of Ontario Power Generation Inc. (OPG) in the electricity sector. This report describes the future structure of OPG with reference to the appropriate corporate governance and senior management structure. It also discusses the potential refurbishing of the Pickering A nuclear generating Units 1, 2 and 3. The electricity system in Ontario is becoming increasingly fragile. The province relies heavily on electricity imports and the transmission system is being pushed to near capacity. Three nuclear generating units are out of service. The problems can be attributed to the fact that the electricity sector has been subjected to unpredictable policy changes for more than a decade, and that the largest electricity generator (OPG) has not been well governed. OPG has had frequent senior management change, accountability has been weak, and cost overruns have delayed the return to service of the Pickering nuclear power Unit 4. It was noted that the generating assets owned and operated by OPG are capable of providing more than 70 per cent of Ontario's electricity supply. Decisive action is needed now to avoid a potential supply shortage of about 5,000 to 7,000 megawatts by 2007. In its current state, OPG risks becoming a burden on ratepayers. Forty recommendations were presented, some of which suggest that OPG should become a rate-regulated commercial utility focused on running and maintaining its core generating assets. This would require that the government act as a shareholder, and the company operate like a commercial business. It was also emphasized that the market must be allowed to bring in new players. refs., tabs., figs

  9. Community Pharmacist-Provided Osteoporosis Screening and Education: Impact on Patient Knowledge

    Directory of Open Access Journals (Sweden)

    Andrea L. Brookhart

    2015-01-01

    Full Text Available Objective: To evaluate the impact pharmacist-provided screening and education had on patient knowledge of osteoporosis and preventive strategies. Methods: A prospective, randomized, controlled study was conducted at 16 locations of a national supermarket chain pharmacy in the Richmond, Virginia area. Women 30 years and older with no history of osteoporosis were enrolled in the study. Patients self-selected into the study by agreeing to the bone density screening, pharmacist-provided education, and completion of a knowledge survey. Subjects were randomized to complete the osteoporosis-related knowledge survey either before (Group A or after (Group B the screening and education session. The survey was developed after guideline and literature evaluation and was pretested with a group of patients for content and clarity. The survey evaluated knowledge of osteoporosis, risk factors for the disease, appropriate age for testing, and preventive strategies. Groups A and B were compared using t-tests. Results: A total of 110 women were enrolled in the study. The mean (±SD age was 52.5 ± 13.1 years in Group A (n=52 and 52.7 ± 11.5 years in Group B (n=58. Knowledge scores were higher in the group who received pharmacist-provided education prior to completing the survey in each category (knowledge of the disease, risk factors, preventive strategies, and appropriate age for testing and overall (p<0.001. Conclusions: Community pharmacist-provided osteoporosis screening and education increased patient knowledge about osteoporosis and preventive strategies. Community pharmacist involvement with increasing patient knowledge may empower patients to engage in prevention strategies to improve bone mass.   Type: Original Research

  10. Osteoporosis

    Science.gov (United States)

    ... age, bones naturally become less dense. In other words, everyone's going to lose some bone density as he or she ages, so you want to start out with as much as possible. Your big chance to build bones is when you're ...

  11. Osteoporosis

    Science.gov (United States)

    ... federal government website managed by the Office on Women's Health in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services . 200 Independence Avenue, S.W., Washington, DC 20201 1-800-994- ...

  12. Evaluation of a clinical decision support tool for osteoporosis disease management: protocol for an interrupted time series design.

    Science.gov (United States)

    Kastner, Monika; Sawka, Anna; Thorpe, Kevin; Chignel, Mark; Marquez, Christine; Newton, David; Straus, Sharon E

    2011-07-22

    Osteoporosis affects over 200 million people worldwide at a high cost to healthcare systems. Although guidelines on assessing and managing osteoporosis are available, many patients are not receiving appropriate diagnostic testing or treatment. Findings from a systematic review of osteoporosis interventions, a series of mixed-methods studies, and advice from experts in osteoporosis and human-factors engineering were used collectively to develop a multicomponent tool (targeted to family physicians and patients at risk for osteoporosis) that may support clinical decision making in osteoporosis disease management at the point of care. A three-phased approach will be used to evaluate the osteoporosis tool. In phase 1, the tool will be implemented in three family practices. It will involve ensuring optimal functioning of the tool while minimizing disruption to usual practice. In phase 2, the tool will be pilot tested in a quasi-experimental interrupted time series (ITS) design to determine if it can improve osteoporosis disease management at the point of care. Phase 3 will involve conducting a qualitative postintervention follow-up study to better understand participants' experiences and perceived utility of the tool and readiness to adopt the tool at the point of care. The osteoporosis tool has the potential to make several contributions to the development and evaluation of complex, chronic disease interventions, such as the inclusion of an implementation strategy prior to conducting an evaluation study. Anticipated benefits of the tool may be to increase awareness for patients about osteoporosis and its associated risks and provide an opportunity to discuss a management plan with their physician, which may all facilitate patient self-management.

  13. Improving compliance with hormonal replacement therapy in primary osteoporosis prevention

    DEFF Research Database (Denmark)

    Vestergaard, P; Hermann, A P; Gram, J

    1997-01-01

    To evaluate whether introduction of treatment alternatives would improve compliance with hormonal replacement therapy (HRT) as primary osteoporosis prevention in women not tolerating the first line osteoporosis prevention schedule.......To evaluate whether introduction of treatment alternatives would improve compliance with hormonal replacement therapy (HRT) as primary osteoporosis prevention in women not tolerating the first line osteoporosis prevention schedule....

  14. Recurrent Hip Fracture Prevention With Osteoporosis Management

    Directory of Open Access Journals (Sweden)

    A. Shahla

    2007-02-01

    Full Text Available Background:Osteoporosis is a major public health threat,and hip fracture is a serious consequence of osteoporosis.Apatient with an osteoporosis-related hip fracture has an increased risk for a second hip fracture.The effect of osteoporosis management on the risk of recurrent hip fracture was evaluated in this study.Methods:58 hip fracture patients older than 50yr and BMD < 2.5 were discharged from hospital with Ca-Vitamin D- Alendronate prescriptions, and followed up for 4 years to determine the rate of recurrent hip fractures. Rate of second hip fractures was compared with 58 hip fractures in the control group (without osteoporosis treatment which were also followed for 4 years. Results:72% of patients continued treatment for 2 years. There were no second hip fractures in the critical first 12 months in the treated group.Overall second hip fractures in osteoporosis treated and control groups were 3.4% and 8.6%(p<0.03, respectively.Conclusion:Management of hip fractures in the elderly should include bone mineral density determination and osteoporosis treatment to prevent further fractures.

  15. Functioning of active postmenopausal women with osteoporosis

    Directory of Open Access Journals (Sweden)

    Aline Cristiane Binda

    Full Text Available Abstract Introduction: The multiple aspects of disability in patients with osteoporosis require comprehensive tool for their assessment. The International Classification of Functioning, Disability and Health (ICF is designed to describe the experience of such patients with theirs functioning. Objective: This study aimed to describe the functioning in a sample of active postmenopausal women with osteoporosis according to the brief ICF core set for osteoporosis. Methods: This cross-sectional study was conducted among active community-dwelling older adults in a southern Brazilian city. Participants were enrolled by convenience sampling from a group conducting supervised aquatic and land-based exercises. Active postmenopausal women with osteoporosis were included. Thirty-two women (mean age 68.0 ± 5.1 years old participated in the evaluation. The brief ICF core set for osteoporosis was used to establish functional profiles. The categories were considered valid when ≥20% of participants showed some disability (according to ICF qualifiers. Results: No category showed a high level of disability, as >50% of women rated by qualifiers .3 or .4. Only the category e580 was considered by all participants as a facilitator. Conclusion: The brief ICF core set for osteoporosis results demonstrated that this classification system is representative to describe the functional profile of the sample. Active postmenopausal women with osteoporosis presented few impairments related to body functions and structures, activities and participation and environmental factors.

  16. High prevalence of osteoporosis in Saudi men

    International Nuclear Information System (INIS)

    El-Desouki, Mahmoud I.; Sulimani, Riyadh A.

    2007-01-01

    Objective was to determine the prevalence of osteoporosis in healthy Saudi men. We randomly recruited 429 Saudi men from the community. The recruited Saudi men were subjected to an interview to reveal their lifestyle parameters, calcium intake and level of activity. Bone densitometry was assessed at lumbar spine (L-4) and the femoral neck. The dual x-ray absorptiometry (DXA) scan was carried out in the Nuclear Medicine at King Khalid University Hospital, Riyadh, Saudi Arabia from September 2002 to December 2004. The World Health Organization definition of low bone mineral density was used. Poor oral calcium intake and low level of daily activity were noted. The overall prevalence of osteopenia for the lumbar spine in the whole group was 35.7% while osteoporosis was present in 21.4% of the subjects. In the femoral neck, osteopenia was noted in 38% and osteoporosis in 11.4%. When either lumbar spine or femoral neck osteoporosis is used for diagnosis, the prevalence of osteoporosis rises to 23.5%. Within the whole group, osteopenia and osteoporosis were more common in individuals above the age of 50 than those below 50 years old. Low bone mineral density occurs with high frequency in Saudi men. Lumbar spine appears to be affected to a higher degree. The reason for the high prevalence of osteoporosis in Saudi men is unclear. Possible underlying causes include nutritional, life style and genetic factors. (author)

  17. Clinical guidelines and the fate of medical autonomy in Ontario.

    Science.gov (United States)

    Rappolt, S G

    1997-04-01

    Conceptually, clinical guidelines and professional autonomy have a paradoxical relationship. Despite being the quintessence of medical knowledge at the corporate level, guidelines diminish the clinical autonomy of individual practitioners, and therefore threaten medicine's justification for its autonomy. Theorists have argued that professional autonomy will be retained through elite dominance of practitioners, while comparative research suggests that economic autonomy can be traded off to retain clinical autonomy. Under government pressure to regulate the growth of Ontario physicians' fee-for-service public expenditure, the profession's representative organization, the Ontario Medical Association (OMA), promoted voluntary clinical guidelines, hoping to both constrain costs and preserve professional control over the content of medical care. The OMA collaborated with the Ministry of Health in developing guidelines and establishing a provincial centre for health service research. Ontario's practitioners disregarded the OMA's exhortations to implement clinical guidelines, suggesting that in the absence of external constraints, practitioners can subvert elite dominance. However, practitioners' unchecked clinical and economic autonomy, combined with evidence of wide provincial variations in medical care, served to legitimize the government's increasingly unilateral control over the schedule of insured medical services, and, in 1993, their imposition of a global cap on physicians' fee-for-service income pool. When analysed in the context of ongoing Ministry-OMA relations, the failure of the OMA's guidelines strategy to constrain medical service costs has expedited an overall decline in medical autonomy in Ontario. The emergence and course of Ontario's clinical guidelines movement is consistent with the view that medical autonomy is contingent upon broad class forces, and the conceptualization of professional organizations as instruments for mediated occupational control.

  18. SCOPE: a scorecard for osteoporosis in Europe.

    Science.gov (United States)

    Kanis, J A; Borgström, F; Compston, J; Dreinhöfer, K; Nolte, E; Jonsson, L; Lems, W F; McCloskey, E V; Rizzoli, R; Stenmark, J

    2013-01-01

    The scorecard summarises key indicators of the burden of osteoporosis and its management in each of the member states of the European Union. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. The scorecard for osteoporosis in Europe (SCOPE) is an independent project that seeks to raise awareness of osteoporosis care in Europe. The aim of this project was to develop a scorecard and background documents to draw attention to gaps and inequalities in the provision of primary and secondary prevention of fractures due to osteoporosis. The SCOPE panel reviewed the information available on osteoporosis and the resulting fractures for each of the 27 countries of the European Union (EU27). The information researched covered four domains: background information (e.g. the burden of osteoporosis and fractures), policy framework, service provision and service uptake e.g. the proportion of men and women at high risk that do not receive treatment (the treatment gap). There was a marked difference in fracture risk among the EU27. Of concern was the marked heterogeneity in the policy framework, service provision and service uptake for osteoporotic fracture that bore little relation to the fracture burden. For example, despite the wide availability of treatments to prevent fractures, in the majority of the EU27, only a minority of patients at high risk receive treatment for osteoporosis even after their first fracture. The elements of each domain in each country were scored and coded using a traffic light system (red, orange, green) and used to synthesise a scorecard. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. The scorecard will enable healthcare professionals and policy makers to assess their country's general approach to the disease and provide indicators to inform future provision of healthcare.

  19. [Ontario Hydro International Inc.]. Annual report 1993

    International Nuclear Information System (INIS)

    1994-01-01

    Ontario Hydro International Inc. is the international representative of Ontario Hydro. OHII operates as a global utility that markets Ontario Hydro's services and products. Its mission is to be the leader in energy efficiency and sustainable development in the international marketplace. This report describes the year's activities in the following areas: Energy management and environment, hydroelectric generation, nuclear products and services, fossil generation, grid (transmission) business, utility management, Asia Power Group Inc. The document also includes financial highlights and international and customer contracts

  20. The safety of Ontario's nuclear reactors

    International Nuclear Information System (INIS)

    1980-06-01

    A Select Committee of the Legislature of Ontario was established to examine the affairs of Ontario Hydro, the provincial electrical utility. Extensive public hearings were held on several topics including the safety of nuclear power reactors operating in Ontario. The Committee found that these reactors are acceptably safe. Many of the 24 recommendations in this report deal with the licensing process and public access to information. (O.T.)

  1. Osteoporosis in Men with Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Claire Issa

    2011-01-01

    Full Text Available Osteoporosis is more common in women than in men. The prevalence in men is not defined yet; however it is becoming much more recognized as its prevalence and impact have become explicable. It is estimated that around 1% of bone mineral density is lost in men every year. Studies show that secondary osteoporosis is the major cause thus, making it important to define the disorders associated with male osteoporosis. Diabetes is a risk factor for bone fractures. In male patients with diabetes measures should be undertaken such as encouraging exercise, assuring adequate calcium and vitamin D intake, and treating diabetic complications.

  2. Diagnosis of osteoporosis through two photon densitometry

    International Nuclear Information System (INIS)

    Marone, M.M.S.; Lewin, S.; Bianco, A.C.; Correa, P.H.S.

    1989-01-01

    Osteoporosis is often diagnosed after fracture occurrence, when therapy is less effective. The dual photon densitometry has been the proposed method for osteoporosis early diagnosis. In the present study is presented our experience on the lumbar vertebral and femoral neck bone mass measurement by utilizing a Lunar DP-3 densitometer in normal young 82 volunteers and 103 women with radiologically and clinically diagnosed osteoporosis. The values found in osteoporotical patients were significantly lower when compared to those normals either in lumbar vertebrae (L2-L4) or in the femoral neck. The method's coefficient of variation was [pt

  3. Alternative models for restructuring Ontario's electric sector

    International Nuclear Information System (INIS)

    Bright, D.; Salaff, S.

    1996-01-01

    The future of Ontario Hydro and the provincial electrical sector was discussed. Various models proposed for restructuring Ontario's electric sector were described and views of some of the stake holders were presented, among them the views of AMPCO, MEA, the Ontario Chamber of Commerce, IPPSO, Ontario Hydro Management, Energy Probe and the Power Workers' Union. In general, most stake holders were in favour of privatization to some degree except for the Power Workers' Union which was unalterably opposed to privatization, claiming that it would lead to quantum increases in electricity rates. 2 figs

  4. [Ontario Hydro]. Corporate performance report, 1993

    International Nuclear Information System (INIS)

    1994-01-01

    Summarizes Ontario Hydro's corporate performance for the year, with actual results being compared against planned values established in the approved corporate financial plan and work program budget. Also includes additional indicators that illustrate noteworthy trends in corporate performance. Corporate results are reported under the new organizational structure implemented in mid-1993, beginning with overall results in such areas as customer satisfaction, electricity sales, human resources, and environmental protection. This is followed by reports from the Electricity Group (supply, generation, transmission), the Energy Services and Environment Group (load saved and shifted, non-utility generation, retail distribution), and Ontario Hydro enterprises (Ontario Hydro Technologies, Ontario Hydro International). The appendix contains summary financial statements

  5. The restructuring of the Ontario electricity market

    International Nuclear Information System (INIS)

    Doucet, J.A.

    1999-01-01

    A summary of the current status of the deregulation of the electricity market in Ontario was presented. To follow global deregulation trends, the Ontario Government has embarked on a considerable restructuring of the Ontario electricity market. The monopoly position of Ontario Hydro has been removed by restructuring the provincial utility into two separate companies, GENCO and SERVCO, which will be responsible for the generation and transmission and distribution of electricity, respectively. Other mechanisms put in place to favour a free and competitive market for electricity in the province, such as the arrival on the market of other electricity producers, and the establishment of the independent market operator, are also discussed. 2 tabs

  6. The Education Act (Ontario) 1980: A Review.

    Science.gov (United States)

    Hodder, C. J.

    1984-01-01

    Ontario has provided special education legislation through the Education Amendment Act, 1980. Issues related to teacher preparation for special education and program planning and implementation are reviewed. (DF)

  7. OSTEOPOROSIS IN SYSTEMIC LUPUS ERYTHEMATOSUS

    Directory of Open Access Journals (Sweden)

    N V Seredavkina

    2009-01-01

    Full Text Available Patients with systemic lupus erythematosus (SLE form a high risk group osteoporosis (OP. Its main causes are autoimmune inflammation, concomitant pathology, and their treatment. When OP occurs in SLE, bone mass loss is shown to occur early and is associated with the use of glucocorticosteroids (GC. To prevent OP, all patients with SLE should modify their lifestyle. To verify bone changes, densitometry is performed in patients who have risk factors of OP and/or a menopause. Calcium preparations and vitamin D are used to prevent OP; bisphosphonates that significantly reduce the risk of fractures of the vertebral column and femoral neck are employed for therapy of OP. A SLE patient with gluco-corticoid-induced OP and a good effect of bisphophonate treatment is described.

  8. [Postmenopausal osteoporosis in obese women].

    Science.gov (United States)

    Izmozherova, N V; Popov, A A

    2008-01-01

    assessment of frequency of obesity and comorbidities in women with postmenopausal osteoporosis (OP). cross-sectional study included 243 postmenopausal symptomatic women with OP diagnosed by dual energy lumbar spine absorptiometry. normal body mass was found in 74 women (30.5%), 105 persons (43.2%) had overweight and 64 patients (26.3%) were obese. Obese OP patients had significantly higherfrequency of arterial hypertension, chronic heart failure, osteoarthritis and glucose metabolism disorders than those with normal body mass. Obese persons also had more severe menopausal symptoms than women with normal body mass. There was no difference in non-traumatic fractures between obese, overweight and slim patients. Thus, postmenopausal OP in obese women was associated with numerous comorbidities and more severe menopausal symptoms.

  9. Integrating a gender dimension into osteoporosis and fracture risk research.

    Science.gov (United States)

    Geusens, Piet; Dinant, Geertjan

    2007-01-01

    Sex (referring to the strict biological sense) and gender (referring to the sociocultural dimension) are major determinants of health and disease. This review examines similarities and differences between the sexes in the prevalence of osteoporosis and fractures, bone- and fall-related risk factors for incident fractures, and the possibilities of fracture prevention, as well as gender differences in the perception of osteoporosis. We reviewed recent English-language publications on sex and gender differences in the context of osteoporosis and fracture risk. We refer to several reviews that provide extensive reference lists on the topics discussed. The incidence of fractures is higher in boys than in girls. The burden of fractures in adults increases with age, and it starts earlier and is higher in adult women than in adult men. With life expectancy increasing, the annual number of fractures is likely to increase substantially. Fractures in adults contribute to increased mortality (more in men than in women), increased morbidity (equal in men and women), and high costs (greater for women than for men). Adult men experience fewer fractures than women do. Men build larger bones with better microarchitecture while they are growing and thereafter have less increase in bone remodeling. Furthermore, they develop bone loss at a later age. Compared with their female counterparts, fewer older men are hypogonadic, and life expectancy is shorter for men than for women. There are multiple reasons for the differences in the incidences of fractures between men and women, related to the many factors associated with both bone and falls that influence fracture risk from the molecular and cellular level to the organ level. Sex hormones play a central and essential role in the physiology of bone by direct and indirect mechanisms (eg, by interfering with the growth hormone and insulin-like growth factor-1 axis). Case-finding strategies to identify patients at highest risk for fractures

  10. Current and future treatment options in osteoporosis.

    LENUS (Irish Health Repository)

    Brewer, Linda

    2011-04-01

    The incidence of osteoporosis-related fractures will increase substantially over the coming decades as the population ages globally. This has important economic and public health implications, contributing substantially to morbidity and excess mortality in this population.

  11. Osteoporosis Amongst Jordanians: Effect of Pharmacist- Directed ...

    African Journals Online (AJOL)

    Gender, education and ... educational programs, which cover more areas of osteoporosis knowledge, and that should not ... the age of 80, the gender difference was ... biases. Statistical analysis. Descriptive statistics were used to describe.

  12. Pregnancy- and lactation-associated osteoporosis

    African Journals Online (AJOL)

    2012-08-08

    Aug 8, 2012 ... A syndrome of spontaneous fractures that occurred ... and the use of specific osteoporosis drugs, preferably those with short-term bone retention. Although there is no .... in relation to geographical region, body composition,.

  13. Recovery From SIADH-Associated Osteoporosis

    DEFF Research Database (Denmark)

    Sejling, Anne-Sophie; Thorsteinsson, Anne-Luise; Pedersen-Bjergaard, Ulrik

    2014-01-01

    INTRODUCTION: Recent studies show an association between hyponatremia and osteoporosis. We have previously reported a case of severe male osteoporosis due to chronic syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Here, we provide a follow-up on this case after cure...... of the condition that further supports the causal relationship. THE CASE: A 38-year-old man had been diagnosed with severe osteoporosis most likely due to chronic SIADH. The SIADH was believed to be idiopathic. A magnetic resonance imaging scan, however, revealed a tumor in the sinus, and biopsies showed...... in the lumbar vertebrae. CONCLUSION: This case provides evidence for a causal relationship between SIADH and chronic hyponatremia and impaired bone metabolism that can lead to severe secondary osteoporosis. The effect on bone metabolism is at least partially reversible....

  14. Experiences of being diagnosed with osteoporosis

    DEFF Research Database (Denmark)

    Rothmann, Mette Juel; Jakobsen, P R; Myhre Jensen, Charlotte

    2018-01-01

    This systematic review provides synthesised knowledge and guidance to health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient's point of view. Using individuals' experiences and meanings can promote tailored and targeted information...... an individual's experience of being diagnosed with osteoporosis at different stages, and secondly, to use a systematic approach to develop a conceptual understanding of central issues relevant for health professionals in order to provide support and guidance to patients/individuals. METHODS: This study used...... of the diagnosis based on self-perceived fracture risk, self-perceived severity of osteoporosis and at the same time, self-perceived health. CONCLUSIONS: This meta-synthesis provides knowledge for health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient's point...

  15. Osteoporosis in men: a case report

    Directory of Open Access Journals (Sweden)

    Ligia J. Dominguez

    2010-09-01

    Full Text Available Osteoporosis in men is frequently not considered, underdiagnosed and often undertreated. In contrast with osteoporosis occurring in women, the genesis is frequently secondary (30-60% with a complex diagnostic approach. A careful anamnesis and physical examination associated with laboratory and instrumental evaluation are necessary for an accurate diagnosis. The clinical case presented concerns a 70-year-old man with negative family history for osteoporosis and a personal history of depression, HBV carrier, and chronic obstructive pulmonary disease (COPD in a heavy ex-smoker with history of alcoholism. The comprehensive geriatric evaluation allowed us to diagnose a multifactorially secondary osteoporosis associated to osteomalacia probably generated by the combination of alcohol abuse with consequent severe malnutrition, heavy smoking and COPD, physical inactivity and rapid weight loss.

  16. Naturalization of landscaped parkland at Ontario Hydro's Nanticoke generating station

    International Nuclear Information System (INIS)

    McKenna, G.R.

    1998-01-01

    The implementation of a program for the naturalization of Nanticoke Park, a 30 hectare area located on the property of Ontario Hydro's Nanticoke Generating Station was discussed. The station, which is located in southern Ontario very near to noted wildlife areas, is the largest coal-fired generating station in North America. Naturalization of Nanticoke Park began with passive naturalization of interior areas. An active naturalization program involving four to five hectare size areas annually was begun in 1997, to be completed over a five -year period. This presentation described the site preparation, planting methods, post-planting tending methods, survival assessment of planted areas, and scientific research initiatives including mulch trials with zebra mussel shells to increase soil moisture. The lessons learned from the two year experiment in determining the optimum planting strategy and methods were described. 7 refs., 1 tab

  17. Osteoporosis in paediatric patients with spina bifida

    OpenAIRE

    Marreiros, Humberto; Loff, Clara; Calado, Eulalia

    2012-01-01

    The prevalence andmorbidity associated with osteoporosis and fractures in patients with spina bifida (SB) highlight the importance of osteoporosis prevention and treatment in early childhood; however, the issue has received little attention. The method for the selection of appropriate patients for drug treatment has not been clarified. Objective: To review the literature concerning fracture risks and low bone density in paediatric patients with SB. We looked for studies describing state...

  18. Balance control in elderly people with osteoporosis

    OpenAIRE

    Hsu, Wei-Li; Chen, Chao-Yin; Tsauo, Jau-Yih; Yang, Rong-Sen

    2014-01-01

    Osteoporosis is a prevalent health concern among older adults and is associated with an increased risk of falls that incur fracture, injury, or mortality. Identifying the risk factors of falls within this population is essential for the development of effective regimes for fall prevention. Studies have shown that muscle quality and good posture alignments are critical for balance control in elderly individuals. People with osteoporosis often have muscle weakness and increased spine kyphosis l...

  19. Nuclear power at Ontario Hydro

    International Nuclear Information System (INIS)

    Tapon, F.; Osborne, T.J.

    1980-01-01

    This case study shows that the diffusion of nuclear power in the electric public utility industry in Canada approximates the logistic growth curve, in agreement with previous results on technological innovation diffusion in the U.S. private sector. Many of the economic variables that affect this diffusion in the private sectors in the U.S. and Canada are also significant in the public sector in Canada. Too few utilities have adopted nuclear technology to permit using regression analysis to study the effect of environmental and regulatory factors on the growth of Ontario Hydro. Thus, cost-benefit analysis for each province might be more effective

  20. The Ontario Energy Marketers Association

    International Nuclear Information System (INIS)

    Baker, W.F.C.

    1998-01-01

    An overview of the role of the Ontario Energy Marketers Association (OEMA) and its future orientation was presented. Participants in the OEMA include agents, brokers, marketers, local distribution companies, public interest representatives, associations and government representatives. The role of the OEMA is to encourage open competition for the benefit and protection of all energy consumer and market participants. As well, the OEMA serves as a forum for key industry stakeholders to resolve market issues outside the regulatory arena, set standards and codes of practice, establish customer education programs, and develop industry input into public policy making

  1. The impact of fragility fracture and approaches to osteoporosis risk assessment worldwide.

    Science.gov (United States)

    Curtis, Elizabeth M; Moon, Rebecca J; Harvey, Nicholas C; Cooper, Cyrus

    2017-11-01

    Osteoporosis constitutes a major public health problem, through its association with age-related fractures, particularly of the hip, vertebrae, distal forearm and humerus. Substantial geographic variation has been noted in the incidence of osteoporotic fractures worldwide, with Western populations (North America, Europe and Oceania), reporting increases in hip fracture throughout the second half of the 20th century, with a stabilisation or decline in the last two decades. In developing populations however, particularly in Asia, the rates of osteoporotic fracture appears to be increasing. The massive global burden consequent to osteoporosis means that fracture risk assessment should be a high priority among health measures considered by policy makers. The WHO operational definition of osteoporosis, based on a measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), has been used globally since the mid-1990s. However, although this definition identifies those at greatest individual risk of fracture, in the population overall a greater total number of fractures occur in individuals with BMD values above the threshold for osteoporosis diagnosis. A number of web-based tools to enable the inclusion of clinical risk factors, with or without BMD, in fracture prediction algorithms have been developed to improve the identification of individuals at high fracture risk, the most commonly used globally being FRAX®. Access to DXA, osteoporosis risk assessment, case finding and treatment varies worldwide, but despite such advances studies indicate that a minority of men and women at high fracture risk receive treatment. Importantly, research is ongoing to demonstrate the clinical efficacy and cost-effectiveness of osteoporosis case finding and risk assessment strategies worldwide. The huge burden caused by osteoporosis related fractures to individuals, healthcare systems and societies should provide a clear impetus for the progression of such

  2. Reprint of: The impact of fragility fracture and approaches to osteoporosis risk assessment worldwide.

    Science.gov (United States)

    Curtis, Elizabeth M; Moon, Rebecca J; Harvey, Nicholas C; Cooper, Cyrus

    2017-08-01

    Osteoporosis constitutes a major public health problem, through its association with age-related fractures, particularly of the hip, vertebrae, distal forearm and humerus. Substantial geographic variation has been noted in the incidence of osteoporotic fractures worldwide, with Western populations (North America, Europe and Oceania), reporting increases in hip fracture throughout the second half of the 20th century, with a stabilisation or decline in the last two decades. In developing populations however, particularly in Asia, the rates of osteoporotic fracture appears to be increasing. The massive global burden consequent to osteoporosis means that fracture risk assessment should be a high priority amongst health measures considered by policy makers. The WHO operational definition of osteoporosis, based on a measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), has been used globally since the mid-1990s. However, although this definition identifies those at greatest individual risk of fracture, in the population overall a greater total number of fractures occur in individuals with BMD values above threshold for osteoporosis diagnosis. A number of web-based tools to enable the inclusion of clinical risk factors, with or without BMD, in fracture prediction algorithms have been developed to improve the identification of individuals at high fracture risk, the most commonly used globally being FRAX ® . Access to DXA, osteoporosis risk assessment, case finding and treatment varies worldwide, but despite such advances studies indicate that a minority of men and women at high fracture risk receive treatment. Importantly, research is ongoing to demonstrate the clinical efficacy and cost-effectiveness of osteoporosis case finding and risk assessment strategies worldwide. The huge burden caused by osteoporosis related fractures to individuals, healthcare systems and societies should provide a clear impetus for the progression of such

  3. Examining Competition in Ontario's Higher Education Market

    Science.gov (United States)

    Farhan, Bayan Yousef

    2017-01-01

    Financial challenges have forced many publicly funded academic institutions in Ontario to adopt a corporate model and to use market tools to compete in the higher education market and maintain their enrolment and revenue levels. This study has analyzed how competition affects publicly funded universities in Ontario. Competition was examined by…

  4. Ontario Hydro Research Division annual report 1988

    International Nuclear Information System (INIS)

    1988-01-01

    The Research Division of Ontario Hydro conducts research in the fields of chemistry, civil engineering, electrical engineering, mechanical engineering, metallurgy, and operations. Much of the research has a bearing on the safe, environmentally benign operation of Ontario Hydro's nuclear power plants. Particular emphasis has been placed on nuclear plant component aging and plant life assurance

  5. [Overview of acupuncture development in Ontario Canada].

    Science.gov (United States)

    Wang, Fang; Wu, Bin-jiang

    2012-04-01

    The history of acupuncture in Ontario, Canada was traced, and the current status as welI as the prospection were introduced in this paper. Statistics showed that the history of acupuncture in Ontario started in the 1880s, and it was only popular in China Town and Chinese community. In the 1970s, it gradually merged into the mainstream of the society, and entered into a growing period. With the tide of Chinese immigration in the 1980s and 1990s, acupuncture matured rapidly. In 2006, the "Traditional Chinese Medicine Act" was passed in Ontario, it was considered as a milestone in the history of acupuncture. At present, just like the other 23 health care professions, acupuncture has already be included into the legislation system, and become a component of Ontario's health care system. At the same time, the law and regulation may also promote the establishment of "pure Chinese Medicine" in Ontario.

  6. Ontario hydro radioactive material transportation field guide

    International Nuclear Information System (INIS)

    Howe, W.

    1987-01-01

    The recent introduction of both the AECB Transport Packaging of Radioactive Material Regulations and Transport Canada's Transportation of Dangerous Goods Regulations have significantly altered the requirements for transporting radioactive material in Canada. Extensive additional training as well as certification of several hundred Ontario Hydro employees has been necessary to ensure compliance with the additional and revised regulatory requirements. To assist in the training of personnel, an 'active' corporate Ontario Hydro Field Guide for Radioactive Material Transport document has been developed and published. The contents of this Field Guide identify current Ontario Hydro equipment and procedures as well as the updated relevant regulatory requirements within Canada. In addition, to satisfying Ontario Hydro requirements for this type of information over two thousand of these Field Guides have been provided to key emergency response personnel throughout the province of Ontario to assist in their transportation accident response training

  7. Green power opportunities for Ontario

    International Nuclear Information System (INIS)

    Elwell, C.; Rotenberg, E.; Torrie, R.; Poch, D.; Allen, G.

    2002-02-01

    Green energy is defined as the energy generated from renewable and environmentally benign sources. In this document, the authors demonstrated that Ontario possesses the potential to reduce energy waste on an economic basis while generating sufficient green energy to enable the province to decommission its coal burning power plants. In turn, this would lead to a more sustainable energy economy and a lesser reliance on nuclear generation. It was determined that a three-fold policy would enable the province to achieve this goal. First, there is a need to remove hidden subsidies to polluting forms of generation. The second aspect of this policy is the implementation of a robust Demand Side Management Program, and the third aspect calls for the reform of the price of electricity that includes all costs. In this manner, all forms of generation would compete on an equal footing. The authors identified an alternative to immediate price reform in the form of a legislated Renewable Portfolio Standard. A growing percentage of new renewable electricity in the supply portfolio offered by electricity providers would be required by the Renewable Portfolio Standard. It was suggested that the Ontario government adopt this measure before the opening of the electricity market in May 2002, as strong support for the measure is present. 13 refs

  8. The uranium deposits of Ontario

    International Nuclear Information System (INIS)

    Robertson, J.A.

    1981-01-01

    The principal types of uranium deposits in Ontario are carbonatites and fenites, alkalic volcanic rocks, pegiatites, calc-silicate rocks, pyritic quartz-pebble conglomerates, polymictic conglomerates and some pelitic rocks, and various 'pitchblende' deposits including late Precambrian unconformities, possibly late Precambrian diabase dikes, and other unconformities: carbonates, sandstones, lignites, and semi-pelitic rocks of middle and upper Precambrian age. Only red unzoned pegmatite and the pyritic quartz-pebble conglomerate have supported production. Ontario reasonably assured and estimated resources in the economic and subeconomic categories in 1977 amounted to 553 000 tonnes U, and 1977 production was 4000 tonnes U. Measured, indicated, and inferred resources in the Elliot Lake - Agnew Lake area are at least 400 000 tonnes U. The latter deposits are also a significant thorium resource. Geological features reflecting major changes in physics and chemistry are prime controls on distribution of uranium deposits. Geological province and subprovince boundaries, major faults, higher metamorphic grades, domain boundaries related to quartz monzonite batholiths, alkalic complexes, and the distribution of carbonate rocks are examples of such geological features

  9. The low enriched uranium fuel cycle in Ontario

    International Nuclear Information System (INIS)

    Archinoff, G.H.

    1979-02-01

    Six fuel-cycle strategies for use in CANDU reactors are examined in terms of their uranium-conserving properties and their ease of commercialization for three assumed growth rates of installed nuclear capacity in Ontario. The fuel cycle strategies considered assume the continued use of the natural uranium cycle up to the mid-1990's. At that time, the low-enriched uranium (LEU) cycle is gradually introduced into the existing power generation grid. In the mid-2020's one of four advanced cycles is introduced. The advanced cycles considered are: mixed oxide, intermediate burn-up thorium (Pu topping), intermediate burn-up thorium (U topping), and LMFBR. For comparison purposes an all natural uranium strategy and a natural uranium-LEU strategy (with no advanced cycle) are also included. None of the strategies emerges as a clear, overall best choice. (LL)

  10. Diagnostic relevance of a questionnaire for osteoporosis risk assessment - comparison with osteodensitometry data

    International Nuclear Information System (INIS)

    Boyanov, M.

    2001-01-01

    The early detection of osteoporosis is a key factor for reducing associated costs. Clinical risk factors have been used for selection of subjects suitable for bone densitometry. Questionnaires for preliminary osteoporosis risk assessment have already been implemented. The purpose of this study is to apply an original questionnaire for risk assessment and to assess its diagnostic value by comparison to forearm bone mineral density data (BMD). 285 females were included - mean age 53.5 ±8.8 years, 82% were menopausal. The osteoporosis risk was assessed by an original score system based on a questionnaire. Forearm BMD was measured by single-energy x-ray absorptiometry using own reference ranges. Two diagnosis models were tested by 'cluster analysis' - classifications with 3 or 2 diagnostic items. The second proved better. Sensitivity in detecting women with forearm osteoporosis was 86.7%, specificity - 16.5% and 75.8% of all women were correctly classified. The total score distribution in the study population is skewed to the right which reflects the two subgroups - at high and low risk for osteoporosis. The value of a similar questionnaire in the overall strategy for diagnosis and treatment of low BMD is discussed. (author)

  11. Transient Osteoporosis in a Young Man: Case report – Case Report

    Directory of Open Access Journals (Sweden)

    Barış Nacır

    2008-08-01

    Full Text Available Although osteoporosis is defined as being a painless and progressive condition, one special subtype of osteoporosis is reversible and painful. Because it isn’t permanent and is obvious in the hip joint, this condition is called transient osteoporosis of the hip. Typically, the paitents are women in the third trimester of pregnancy and middle-aged men who are seen initially with acute progressive pain, antalgic gait, and severe functional disability involving the affected extremity. Its aetiology remains a matter of speculation, and the same remains true for its treatment. Many researchers have proposed different surgical and non-surgical treatment strategies; but the conservative approach, which takes the form of analgesics, intermittent traction, range of motion exercises, abductor strengthening exercises and restricted weight bearing, is preferred. In this paper we report a 22 years old man with transient osteoporosis of the hip who showed excellent recovery following a conservative approach. (From the World of Osteoporosis 2008;14:35-9

  12. Osteoporosis in survivors of early life starvation.

    Science.gov (United States)

    Weisz, George M; Albury, William R

    2013-01-01

    The objective of this study was to provide evidence for the association of early life nutritional deprivation and adult osteoporosis, in order to suggest that a history of such deprivation may be an indicator of increased risk of osteoporosis in later life. The 'fetal programming' of a range of metabolic and cardiovascular disorders in adults was first proposed in the 1990s and more recently extended to disorders of bone metabolism. Localised famines during World War II left populations in whom the long-term effects of maternal, fetal and infantile nutritional deprivation were studied. These studies supported the original concept of 'fetal programming' but did not consider bone metabolism. The present paper offers clinical data from another cohort of World War II famine survivors - those from the Holocaust. The data presented here, specifically addressing the issue of osteoporosis, report on 11 Holocaust survivors in Australia (five females, six males) who were exposed to starvation in early life. The cases show, in addition to other metabolic disorders associated with early life starvation, various levels of osteoporosis, often with premature onset. The cohort studied is too small to support firm conclusions, but the evidence suggests that the risk of adult osteoporosis in both males and females is increased by severe starvation early in life - not just in the period from gestation to infancy but also in childhood and young adulthood. It is recommended that epidemiological research on this issue be undertaken, to assist planning for the future health needs of immigrants to Australia coming from famine affected backgrounds. Pending such research, it would be prudent for primary care health workers to be alert to the prima facie association between early life starvation and adult osteoporosis, and to take this factor into account along with other indicators when assessing a patient's risk of osteoporosis in later life.

  13. Management of postmenopausal osteoporosis for primary care.

    Science.gov (United States)

    Miller, P; Lukert, B; Broy, S; Civitelli, R; Fleischmann, R; Gagel, R; Khosla, S; Lucas, M; Maricic, M; Pacifici, R; Recker, R; Sarran, H S; Short, B; Short, M J

    1998-01-01

    The shift in health care delivery from a subspecialty to primary care system has transferred the responsibility of preventing osteoporotic fractures from specialists in metabolic bone disease to the web of physicians--family practitioners, general internists, pediatricians, and gynecologists--who provide the bulk of primary care. The challenge for this group of physicians is to decrease the rising prevalence of osteoporotic hip and vertebral fractures while operating within the cost parameters. It is the goal of this brief summary to provide primary practitioners with focused guidelines for the management of postmenopausal osteoporosis based on new and exciting developments. Prevention and treatment will change rapidly over the next decade and these advances will require changes in these recommendations. We identified patients at risk for osteoporosis and provided indications for bone mass measurement, criteria for diagnosis of osteoporosis, therapeutic interventions, and biochemical markers of the disease. Prevention and treatment are discussed, including hormone replacement therapy and use of calcitonin, sodium fluoride, bisphosphonates, and serum estrogen receptor modulators. Postmenopausal osteoporosis should no longer be an accepted process of aging. It is both preventable and treatable. Primary care physicians must proactively prevent and treat osteoporosis in their daily practice, and combination therapies are suggested.

  14. Osteoporosis in paediatric patients with spina bifida.

    Science.gov (United States)

    Marreiros, Humberto; Marreiros, Humberto Filipe; Loff, Clara; Calado, Eulalia

    2012-01-01

    The prevalence and morbidity associated with osteoporosis and fractures in patients with spina bifida (SB) highlight the importance of osteoporosis prevention and treatment in early childhood; however, the issue has received little attention. The method for the selection of appropriate patients for drug treatment has not been clarified. To review the literature concerning fracture risks and low bone density in paediatric patients with SB. We looked for studies describing state-of-the-art treatments and for prevention of secondary osteoporosis. Articles were identified through a search in the electronic database (PUBMED) supplemented with reviews of the reference lists of selected papers. The main outcome measures were incidence of fractures and risk factors for fracture, an association between bone mineral density (BMD) and occurrence of fracture, risk factors of low BMD, and effects of pharmacological and non-pharmacological treatments on BMD and on the incidence of fractures. We considered as a secondary outcome the occurrence of fractures in relation to the mechanism of injury. Results indicated that patients with SB are at increased risk for fractures and low BMD. Risk factors that may predispose patients to fractures include higher levels of neurological involvement, non-ambulatory status, physical inactivity, hypercalciuria, higher body fat levels, contractures, and a previous spontaneous fracture. Limitations were observed in the number and quality of studies concerning osteoporosis prevention and treatment in paediatric patients with SB. The safety and efficiency of drugs to treat osteoporosis in adults have not been evaluated satisfactorily in children with SB.

  15. Teriparatide in the management of osteoporosis

    Directory of Open Access Journals (Sweden)

    Donald Bodenner

    2008-01-01

    Full Text Available Donald Bodenner, Carolyn Redman, Ann RiggsDepartment of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USAAbstract: Fracture of the hip is frequently a catastrophic event in the elderly, often resulting in death within a year and of the survivors, few regain pre-fracture quality of life. Although less appreciated, fractures of the spine result in significant morbidity and are also associated with increased mortality compared with individuals without a fracture. In recent years there has been an explosion in the development of new drugs for the treatment of osteoporosis. Recombinant human parathyroid hormone (1–34 (20 μg/day is a recent addition to this armamentarium with a novel mechanism of action, which was approved by the US FDA for the treatment of postmenopausal osteoporosis and male osteoporosis secondary to hypogonadism in November 2002. It is the first osteoporosis treatment that leads to the formation of new bone with architecture similar to normal bone. Intense efforts have been made to understand the effect of teriparatide on antiresorptive therapy and vice versa. Although these relationships are not completely understood, the results of recent studies allow clinicians to begin to optimize therapeutic gains in bone mineral density and improve anti-fracture efficacy.Keywords: osteoporosis, teriparatide, fracture

  16. The clinic-statistic study of osteoporosis

    Directory of Open Access Journals (Sweden)

    Florin MARCU

    2008-05-01

    Full Text Available Osteoporosis is the most common metabolic bone disease and is characterized by the shrinkage in bone mass and the distruction of bone quality, thus conferring a higher risk for fractures and injuries. Osteoporosis reaches clinical attention when it is severe enough to induce microfractures and the collapsing of vertebral bodies manifesting with back aches or predisposition to other bone fractures. The aim of the study was to establish a statistic-numeric report between women and men in subjects diagnosed with osteoporosis through DEXA that present with a clinical simptomatology. We studied a group of subjects of masculine and feminine genders that have been diagnosed with osteoporosis through DEXA at the EURORAD clinic in Oradea from 01.01.2007-to present time .The result of the study was that the simptomatology of osteoporosis with pain and even cases of fractures is more obvious in female subjects then in male patients; statistically ,a woman/man report of 6.1/1 was established.

  17. Bone turnover in postmenopausal osteoporosis

    International Nuclear Information System (INIS)

    Thomsen, K.

    1988-02-01

    Studies of the bone turnover in postmenopausal osteoporosis are essential, because the associated bone loss is inevitably due to the relative increase of bone resorption compared with bone formation. Measurement of the bone mineral content (BMC) in normal adults is assessed - partly on the uncorrected values and partly in proportion to the body muscle mass. The whole body retention (WBR) method is presented. The WBR and alternative urinary excretion (UE) methods used by the author are characterised and compared with the retention methods described in the literature. The representativity of WBR and UE for the estimation of bone turnover in normal subjects and patients with various bone metabolic diseases is discussed. The conclusion is that the modified retention methods used by the author have a satisfactory precision and accuracy in relation to the clinical studies carried out. The author's modification of the WBR method for determination of bone turnover and the alternative urinary excretion method (UE) consists in continuous scanning in the whole body count, using a gamma camera, and with the collimator a short distance from the volunteer. This procedure has the advantage of restricting the radioactive dose to 2 mCi (72 MBa). This is smaller by a factor of 5-10 than the dose used to measure WBR with equally simple counting equipment: With the author's procedure, using frontal counting, WBR is systematically underestimated by about 4 per cent point compared to the purely dorsal count, but since the frontal position is the most comfortable, requires a smaller radioactive dose, and the error is systematic, it is the preferred counting procedure. Correction of WBR and UE for bone mineral content is in principle a new parameter of bone turnover, whose improved accuracy increases the validity of the retention determinations. 136 refs. (EG)

  18. What People with Rheumatoid Arthritis Need to Know about Osteoporosis

    Science.gov (United States)

    ... Need to Know About Osteoporosis What Is Rheumatoid Arthritis? Rheumatoid arthritis is an autoimmune disease, a disorder in ... new habits for healthy bones. The Link Between Rheumatoid Arthritis and Osteoporosis Studies have found an increased risk ...

  19. Proactive pharmaceutical care interventions decrease patients' nonadherence to osteoporosis medication

    NARCIS (Netherlands)

    Stuurman-Bieze, A G G; Hiddink, E G; van Boven, J F M; Vegter, S

    UNLABELLED: Using a protocolled intervention program, pharmacists can decrease nonadherence to osteoporosis medication, by continuous monitoring and tailored counseling sessions, starting at treatment initiation. In the usual care group, 32.8% of patients initiating osteoporosis medication

  20. Hormone replacement for osteoporosis in women with primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Rudic, Jelena S; Poropat, Goran; Krstic, Miodrag N

    2011-01-01

    Women with primary biliary cirrhosis often suffer from postmenopausal osteoporosis due to their age, or osteoporosis secondary to their liver disease, or treatments provided for their liver disease. Hormone replacement increases bone mineral density and reduces fractures in postmenopausal women...

  1. What People with Lactose Intolerance Need to Know about Osteoporosis

    Science.gov (United States)

    ... Lactose Intolerance Need to Know About Osteoporosis What People With Lactose Intolerance Need to Know About Osteoporosis ... 2 hours after eating dairy products containing lactose, people with lactose intolerance start to develop stomach cramps ...

  2. Thiazide diuretics and hyponatremia in relation to osteoporosis

    DEFF Research Database (Denmark)

    Kruse, Christian

    Hyponatremia, a condition of low serum concentrations of sodium, shares an intertwined and often paradoxical relationship with thiazide diuretics and osteoporosis. In retrospective studies, thiazides have been shown to protect against osteoporosis-related fractures, but also to cause hyponatremia...

  3. Guidelines for the early detection of osteoporosis and prediction of ...

    African Journals Online (AJOL)

    Endorsed by the Medical Association of. South Africa. ... Osteoporosis,2 a recent report of a World Health. Organisation ... factors for different types of osteoporosis (e.g. hip v. spine) ... technology, does not appear to be of clinical advantage,.

  4. Side Effects of HIV Medicines: HIV and Osteoporosis

    Science.gov (United States)

    ... risk factors for osteoporosis include a poor diet, physical inactivity, and smoking. These risk factors can be managed ... and vitamin D increases the risk of osteoporosis. Physical inactivity : Bones become stronger with exercise, so physical inactivity ...

  5. Management of glucocorticoids-induced osteoporosis: role of teriparatide

    Directory of Open Access Journals (Sweden)

    Silvia Migliaccio

    2009-04-01

    Full Text Available Silvia Migliaccio1, Marina Brama1, Nazzarena Malavolta21Dipartimento di Fisiopatologia Medica, Policlinico Umberto I, Università degli Studi Sapienza di Roma, Italy; 2Dipartimento di Medicina Interna, Policlinico S Orsola Malpighi, Bologna, ItalyAbstract: Glucocorticoids (GC-induced osteoporosis (GIOP is the most common cause of secondary osteoporosis, which leads to an increased fracture risk in patients. The normal bone turnover depends on a balance between osteoblasts and osteoclasts activity and GC can cause a rapid bone loss, decreasing bone formation and increasing bone resorption. The decreased bone formation is mainly due to the GC-induced apoptosis of both osteoblasts and osteocytes, while the increased bone resorption is due to the increased life-span of pre-existing osteoclasts. Bisphosphonates are clearly effective in preventing and treating GIOP but anabolic therapeutic strategies are the new promising therapeutic alternative. Experimental and clinical studies indicate that teriparatide, the active (1–34 parathyroid hormone (PTH molecule, is efficacious for the treatment of GIOP, being able to induce an increase in bone mass in these patients. Intermittent administration of human PTH (1–34 stimulates bone formation by increasing osteoblast number. Additionally, human PTH (1–34 modulates the level and/or activity of locally produced growth factors and cytokines. Teriparatide has been demonstrated in several clinical studies to significantly decrease the incidence of fractures in patients affected by GIOP. It has recently received an indication for GIOP and its label indication has also been expanded.Keywords: glucocorticoids, osteoblasts, osteoclasts, osteoporosis, teriparatide

  6. Recent trends in the diagnosis of osteoporosis

    International Nuclear Information System (INIS)

    Tsankov, L.; Tochev, N.; Poposki, Sp.

    2015-01-01

    Osteoporosis is a progressive systemic disease of the skeleton that is characterized by reduced mass and impaired mikroarhitektonika bone, leading to enhanced bone fragility and increased risk of fractures. The development of osteoporosis is painless and progresses slowly and gradually, without manifested symptoms over the years, so that patients learn about the disease only at later stages of development or, most often after the occurrence of fracture. By dual-energy X-ray absorptiometry (DXA) of the spine and femoral neck can be diagnosed, to estimate fracture risk and monitor treatment. In the aspect of diagnostic methods such as peripheral dual-energy X-ray absorptiometry (rDXA), quantitative ultrasound bone (QRS) and quantitative computed tomography (QCT) have their place. Key words: Dual-Energy X-Ray Absorptiometry. Osteoporosis

  7. Refractory Rheumatic Disorder: Atypical Postpregnancy Osteoporosis

    Directory of Open Access Journals (Sweden)

    Cindy Mourgues

    2015-01-01

    Full Text Available This is a case report on a young patient with severe osteoporosis that was initially revealed when she presented with polyarthralgia during her second pregnancy. Postpartum, the pain increased and her X-ray did not show any abnormalities. A bone scintigraphy was performed. It indicated an inflammatory rheumatic disorder. Six months after partum, an investigation of right coxalgia revealed a spontaneous basicervical fracture. Given the persistent polyarthralgia, the patient underwent a new scintigraphy, which revealed areas of what looked to be old rib and L1 fractures. A subsequent full body magnetic resonance imaging (MRI scan revealed signal abnormalities that could indicate multiple lower limb bone fractures. Despite exhaustive biological, radiological, and histological testing, no secondary cause for the osteoporosis was found. The patient was started on teriparatide. We finally concluded that, despite the atypical presentation, the patient was suffering from postpregnancy osteoporosis. It is possible that the frequency of occurrence of this still poorly understood disease is underestimated.

  8. Lived Experiences of “Silent” Osteoporosis

    DEFF Research Database (Denmark)

    Hansen, Carrinna; Konradsen, Hanne; Abrahamsen, Bo

    Background Non-adherence to medical treatment of chronic diseases remains unclear. People with osteoporosis are mostly unaware of the disease, until bone fractures may occur. The medical treatment might be the manifest of the disease before fracture. However, it is unknown how this is experienced...... and affects the individual’s life situation. Aim The aim is to illuminate the human experiences and perspective in relation to living with osteoporosis without fractures, but with prophylactic treatment. Method Descriptive, longitudinal study the approach was phenomenological-hermeneutic. Sixteen women...... with osteoporosis and in prophylactic treatment were included. Data was obtained using individual interviews three times during one year. Data were analyzed at three levels: Naive reading, structural analysis and critical interpretation and discussion. Results The preliminary findings indicate that there are three...

  9. Treatment of osteoporosis after alendronate or risedronate

    DEFF Research Database (Denmark)

    Eiken, P; Vestergaard, P

    2016-01-01

    Alendronate (ALN) and risedronate (RIS) are ideal as first-choice therapy options in the treatment of postmenopausal osteoporosis. What to do for patients who do not respond adequately to bisphosphonates has not been conclusively determined, but transitioning to other therapies should be considered....... The aim of this article is to describe potential alternatives for patients switching from ALN or RIS to other therapies for osteoporosis. A systematic search of PubMed was conducted to find papers that evaluate the effects of switching therapies on fractures, bone mineral density (BMD), or bone turnover...... markers. Results from 11 studies that prospectively assessed treatment after ALN or RIS in women with postmenopausal osteoporosis were reviewed. All studies are of short duration (all 24 months or less) and assess the topic of transitioning therapy from ALN or RIS. None of the studies had the statistical...

  10. Imaging of vertebral fracture in osteoporosis

    International Nuclear Information System (INIS)

    Skowronska-Jozwiak, E.; Lewinski, A.; Bieganski, T.

    2008-01-01

    Vertebral collapses are the most frequent fractures in osteoporosis. They are often overlooked, although their presence is a strong risk factor for development of new fractures. Lateral radiographs of the spine are the accepted standard for assessment of fractures. Qualitative (visual), semiquantitative and quantitative (morphometric) techniques are useful in determining the compressive deformities of vertebral bodies. In the present paper, the advantages and the disadvantages of these methods are discussed. The improvement of scan quality allows to use DXA technique to diagnose the fractures, in both - the visual and the morphometric way. The vertebral morphologic assessment also seems to be an important diagnostic tool in pediatric osteoporosis. Application of multidetector CT and especially MR in vertebral imaging of osteoporosis, improves the sensitivity of fracture detection and enables the differentiation of benign from malignant vertebral body collapses. (author)

  11. Fracture risk and zoledronic acid therapy in men with osteoporosis

    DEFF Research Database (Denmark)

    Boonen, Steven; Reginster, Jean-Yves; Kaufman, Jean-Marc

    2012-01-01

    Fractures in men are a major health issue, and data on the antifracture efficacy of therapies for osteoporosis in men are limited. We studied the effect of zoledronic acid on fracture risk among men with osteoporosis.......Fractures in men are a major health issue, and data on the antifracture efficacy of therapies for osteoporosis in men are limited. We studied the effect of zoledronic acid on fracture risk among men with osteoporosis....

  12. Guidelines for the diagnosis, prevention and treatment of osteoporosis

    OpenAIRE

    M. Rossini; G. Rini; R. Nuti; S. Minisola; S. Migliaccio; C. Mereu; L. Masi; C. Marcocci; E. Mannarino; G. Luisetto; G.C. Isaia; S. Gonnelli; S. Giannini; B. Frediani; E. Fiore

    2011-01-01

    The guidelines for the osteoporosis management were first drafted by a working group and then critically evaluated by the board of SIOMMMS. The most relevant points are: Definition: Osteoporosis is defined as a quantitative and qualitative deterioration of bone tissue leading to increased risk of fracture. Postmenopausal and senile osteoporosis are defined as primitive. Diagnosis: The cornerstone for the diagnosis of osteoporosis is the measurement of bone mineral density (BMD) by DXA (dual-e...

  13. Pathophysiology of osteoporosis: new mechanistic insights.

    Science.gov (United States)

    Armas, Laura A G; Recker, Robert R

    2012-09-01

    Understanding of the pathophysiology of osteoporosis has evolved to include compromised bone strength and skeletal fragility caused by several factors: (1) defects in microarchitecture of trabeculae, (2) defective intrinsic material properties of bone tissue, (3) defective repair of microdamage from normal daily activities, and (4) excessive bone remodeling rates. These factors occur in the context of age-related bone loss. Clinical studies of estrogen deprivation, antiresorptives, mechanical loading, and disuse have helped further knowledge of the factors affecting bone quality and the mechanisms that underlie them. This progress has led to several new drug targets in the treatment of osteoporosis. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Operationalizing privacy by design: the Ontario smart grid case study

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-02-15

    The electrical industry is under perpetual evolution and the changes are becoming more and more complex. The current evolution of the Smart Grid in Ontario, Canada, will modify the entire utility infrastructure and it is therefore critical that the proposed solution also meets customer needs. The aim of this paper is to determine how best practices can be operationalized into smart grid systems. This study showed that the easiest, fastest and best way to implement privacy is in the earliest design stage. This study demonstrated the strategy of dealing with privacy after the fact makes it more difficult to satisfy privacy considerations.

  15. Ontario energy market review and outlook

    International Nuclear Information System (INIS)

    Brett, J.T.

    1997-01-01

    The current status of the natural gas industry and the electric power industry in Ontario, in terms of deregulation, was described. Natural gas utilities will exit the regulated gas market over the next few years and transfer their existing residential and small commercial gas contracts to their unregulated affiliates. Nevertheless, a regulated gas supply option will remain until the regulator is assured that consumer protection issues have been properly addressed, and there is a truly competitive market. Ontario Hydro is a vertically integrated virtual monopoly. It lags behind B.C., Alberta, Quebec and Nova Scotia in terms of deregulation and restructuring, although the MacDonald Commission's recent report recommended sweeping changes to Ontario Hydro's monopoly over the electric power industry. A final response from the Ontario government is still pending. The convergence of the electric power and natural gas industries was also discussed

  16. Revitalizing the nuclear business at Ontario Hydro

    International Nuclear Information System (INIS)

    Talbot, K.

    1994-01-01

    Ontario Hydro, North America's largest electric power utility, with an installed capacity of 34,000 MW, has under gone a major restructuring over the past year to better align itself with a changing electricity market and evolving customer needs. The single largest new business unit within the new Ontario Hydro is Ontario Hydro Nuclear (OHN), responsible for engineering, operation and maintenance of the Corporation's 20 large nuclear units at three generating sites, OHN faces a significant challenge in returning Ontario's nuclear units to the world-leading performance levels they enjoyed in the past, particularly the older Pickering A and Bruce A plants. However, steady progress is being made as evidenced by improving peer reviews and overall capacity and financial performance

  17. An ongoing six-year innovative osteoporosis disease management program: challenges and success in an IPA physician group environment.

    Science.gov (United States)

    Woo, Ann; Hittell, Jodi; Beardsley, Carrie; Noh, Charles; Stoukides, Cheryl A; Kaul, Alan F

    2004-01-01

    The goal of this ongoing comprehensive osteoporosis disease management initiative is to provide the adult primary care physicians' (PCPs) offices with a program enabling them to systematically identify and manage their population for osteoporosis. For over six years, Hill Physicians Medical Group (Hill Physicians) has implemented multiple strategies to develop a best practice for identifying and treating members who were candidates for osteoporosis therapy. Numerous tools were used to support this disease management effort, including: evidence-based clinical practice guidelines, patient education sessions, the Simple Calculated Osteoporosis Risk Estimation (SCORE) questionnaire tool, member specific reports for PCPs, targeted member mailings, office-based Peripheral Instantaneous X-ray Imaging (PIXI) test and counseling, dual x-ray absorptiometry (DEXA) scan guidelines, and web-based Electronic Simple Calculated Osteoporosis Risk Estimation (eSCORE) questionnaire tools. Hill Physicians tabulated results for patients who completed 2649 SCORE tests, screened 978 patients with PIXI tests, and identified 338 osteopenic and 124 osteoporotic patients. The preliminary results of this unique six-year ongoing educational initiative are slow but promising. New physician offices express interest in participating and those offices that have participated in the program continue to screen for osteoporosis. Hill Physicians' message is consistent and is communicated to the physicians repeatedly in different ways in accordance with the principles of educational outreach. Physicians who have conducted the program have positive feedback from their patients and office staff and have begun to communicate their experience to their peers.

  18. Prevalence of and risk factors for osteoporosis and fracture among a male HIV-infected population in the UK.

    Science.gov (United States)

    Short, Charlotte-Eve S; Shaw, Simon G; Fisher, Martin J; Walker-Bone, Karen; Gilleece, Yvonne C

    2014-02-01

    Rates of osteoporosis and fracture may be increased in HIV but there are few UK data. Our aim was to examine the prevalence of and risk factors for osteoporosis and fractures among a homogeneous cohort of well-characterized HIV-infected men. In total, 168 men were recruited, median age 45 years, 37 combination antiretroviral therapy (cART) naïve, 46 with exposed longer term (median >10 years). All participants provided information on bone health and underwent DEXA scanning. Osteopenia was found in 58% of subjects and osteoporosis in 12%; 14% reported fractures since HIV diagnosis. Number of fractures since HIV diagnosis was significantly increased among those with osteoporosis (OR 3.5, 95% CI 1.2-10.4, p = 0.018). Duration of infection greater than 13 years was significantly associated with osteoporosis. Duration of cART was associated in univariate but not multivariate analyses. Strategies to prevent osteoporosis and fractures in HIV will require attention to viral and lifestyle factors and not just cART.

  19. Central and peripheral fat body mass have a protective effect on osteopenia or osteoporosis in adults and elderly?

    Science.gov (United States)

    Freitas, P M S S; Garcia Rosa, M L; Gomes, A M; Wahrlich, V; Di Luca, D G; da Cruz Filho, R A; da Silva Correia, D M; Faria, C A; Yokoo, E M

    2016-04-01

    This cross-sectional study involves randomly selected men aged 50 to 99 years and postmenopausal women. Either central fat mass or peripheral fat mass were associated to osteoporosis or osteopenia independently from fat-free body mass and other confounding factors. Obesity and osteoporosis are public health problems that probably share common pathophysiological mechanisms. The question if body fat mass, central or peripheral, is protective or harmful for osteoporosis or osteopenia is not completely resolved. This study aims to investigate the association between osteoporosis or osteopenia, and fat body mass (central and peripheral) independently from fat-free body mass, in men aged 50 to 99 years old and postmenopausal women randomly selected in the community. This is a cross-sectional investigation with a random sample of registered population in Niterói Family Doctor Program (FDP), State of Rio de Janeiro, Brazil. Bone mineral density (BMD) and fat-free mass were assessed by dual X-ray absorptiometry (DXA). There was statistically significant bivariate association between bone loss with gender, age, skin color, alcohol consumption at risk dose, use of thiazide, fat-free body mass, and fat body mass (central and peripheral). In the multiple analysis of fat-free body mass, central and peripheral fat body mass showed an independent and protective effect on the presence of osteoporosis or osteopenia (p value obesity and osteoporosis are public health problems worldwide, strategies aimed at preventing both conditions should be encouraged during aging.

  20. Systemic Mesenchymal Stromal Cell Transplantation Prevents Functional Bone Loss in a Mouse Model of Age-Related Osteoporosis.

    Science.gov (United States)

    Kiernan, Jeffrey; Hu, Sally; Grynpas, Marc D; Davies, John E; Stanford, William L

    2016-05-01

    Age-related osteoporosis is driven by defects in the tissue-resident mesenchymal stromal cells (MSCs), a heterogeneous population of musculoskeletal progenitors that includes skeletal stem cells. MSC decline leads to reduced bone formation, causing loss of bone volume and the breakdown of bony microarchitecture crucial to trabecular strength. Furthermore, the low-turnover state precipitated by MSC loss leads to low-quality bone that is unable to perform remodeling-mediated maintenance--replacing old damaged bone with new healthy tissue. Using minimally expanded exogenous MSCs injected systemically into a mouse model of human age-related osteoporosis, we show long-term engraftment and markedly increased bone formation. This led to improved bone quality and turnover and, importantly, sustained microarchitectural competence. These data establish proof of concept that MSC transplantation may be used to prevent or treat human age-related osteoporosis. This study shows that a single dose of minimally expanded mesenchymal stromal cells (MSCs) injected systemically into a mouse model of human age-related osteoporosis display long-term engraftment and prevent the decline in bone formation, bone quality, and microarchitectural competence. This work adds to a growing body of evidence suggesting that the decline of MSCs associated with age-related osteoporosis is a major transformative event in the progression of the disease. Furthermore, it establishes proof of concept that MSC transplantation may be a viable therapeutic strategy to treat or prevent human age-related osteoporosis. ©AlphaMed Press.

  1. Comments on nuclear reactor safety in Ontario

    International Nuclear Information System (INIS)

    1987-08-01

    The Chalk River Technicians and Technologists Union representing 500 technical employees at the Chalk River Nuclear Laboratories of AECL submit comments on nuclear reactor safety to the Ontario Nuclear Safety Review. Issues identified by the Review Commissioner are addressed from the perspective of both a labour organization and experience in the nuclear R and D field. In general, Local 1568 believes Ontario's CANDU nuclear reactors are not only safe but also essential to the continued economic prosperity of the province

  2. Market prices for solar electricity in Ontario

    International Nuclear Information System (INIS)

    Rowlands, I.H.

    2006-01-01

    The Ontario electricity supply is facing considerable challenges while demand is increasing due to a growing population and increased economic growth needs. In response to these challenges, the government of Ontario established the Ontario Power Authority (OPA) in 2004 to ensure adequate, reliable and secure electricity supply and resources in Ontario. The OPA has also engaged in activities to facilitate the diversification of sources of electricity supply by promoting the use of cleaner energy sources and technologies, including alternative energy sources and renewable energy. The purpose of this paper was to advance discussions regarding the contribution that solar PV can make to Ontario's supply mix. In particular, it determined the value of the electricity that would have been produced by a PV system located in Waterloo, Ontario under the following 4 pricing regimes: (1) the conventional small user tariff system currently in place in Ontario, (2) the time-of-use pricing system that is voluntarily available to those who have smart meters installed in their facilities, (3) the spot market, hourly prices, to which some of Ontario's largest electricity users are exposed, and (4) the recently-proposed rate for standard offer contracts for PV systems. The study showed that a solar PV system that produces 3,000 kWh of electricity over the course of a year would generate different revenue amounts, ranging from the smallest amount of approximately $174.00 to $1,260.00, depending on the pricing regime. The pricing regime that reflects real, time-of-day electricity prices appears to be most advantageous to solar PV systems. It was recommended that additional work is needed regarding the other benefits of solar PV, such as avoided capacity/generation needs, avoided transmission and distribution cost and losses, environmental benefits, and job creation. 3 refs., 4 tabs., 8 figs

  3. Annual report 1993 (Ontario Hydro, Toronto)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-12-31

    Ontario Hydro`s prime objective is to supply the people of Ontario with electricity at cost while maintaining high standards of safety and service. The annual report presents energy efficiency and competitiveness, operations in review, the environmental performance of the Corporation, the future, and choices for a sustainable future. A financial review and analysis is also provided, along with an auditor`s report and financial statements.

  4. Large catchment area recharges Titan's Ontario Lacus

    Science.gov (United States)

    Dhingra, Rajani D.; Barnes, Jason W.; Yanites, Brian J.; Kirk, Randolph L.

    2018-01-01

    We seek to address the question of what processes are at work to fill Ontario Lacus while other, deeper south polar basins remain empty. Our hydrological analysis indicates that Ontario Lacus has a catchment area spanning 5.5% of Titan's surface and a large catchment area to lake surface area ratio. This large catchment area translates into large volumes of liquid making their way to Ontario Lacus after rainfall. The areal extent of the catchment extends to at least southern mid-latitudes (40°S). Mass conservation calculations indicate that runoff alone might completely fill Ontario Lacus within less than half a Titan year (1 Titan year = 29.5 Earth years) assuming no infiltration. Cassini Visual and Infrared Mapping Spectrometer (VIMS) observations of clouds over the southern mid and high-latitudes are consistent with precipitation feeding Ontario's large catchment area. This far-flung rain may be keeping Ontario Lacus filled, making it a liquid hydrocarbon oasis in the relatively dry south polar region.

  5. Ontario's power market post November 11

    International Nuclear Information System (INIS)

    Murphy, P.

    2003-01-01

    This paper provides a review of Ontario's first year with an open electricity market. The year 2002 to 2003 had record energy demands with challenges on the supply side. In particular, generation availability was below expectations during the summer months. This demonstrated that price predictability and volatility needs to be addressed and investment in new power generation is needed in Ontario. Ontario demand forecasts outpace supply for the long term outlook. In addition, most of Ontario's generating plants are aging and will soon exceed their nominal service life, requiring major refurbishment or replacement. Decisions are needed now on the future of coal in Ontario's generation mix. It was also noted that transmission reinforcements are needed in the Greater Toronto Area (GTA). In the short term, consumers can expect delays in return to service of nuclear units, forced extensions to planned outages, and reduced outlook for energy from hydroelectric resources. It was noted that Ontario will continue to rely on imports, although emergency generation is being installed. 5 figs

  6. Alternative Pathways to Legitimacy: Promotional Practices in the Ontario For-Profit College Sector

    Science.gov (United States)

    Pizarro Milian, Roger; Quirke, Linda

    2017-01-01

    This study empirically examines how for-profit career colleges in Ontario, Canada market themselves to prospective students. It uses a mixed-methods approach to review the content of 489 online promotional profiles representing 375 unique for-profit colleges. It finds that for-profit colleges adopt several distinct marketing strategies, including…

  7. Measuring the potential of GHG emissions reductions on the food and beverage processing sector in Ontario

    International Nuclear Information System (INIS)

    Singleton, M.; Ciccone, A.D.

    2000-07-01

    Seven per cent of the greenhouse gas emissions from the industrial sector in Ontario relate to the food and beverage processing sector. This report provides the Ontario Ministry of Agriculture, Food and Rural Affairs with the ability to identify the effects of reducing greenhouse gas emissions on Ontario's food and beverage processing sector. The study was undertaken in response to Ontario's efforts to address the challenges set by the Kyoto Protocol and the proposed release of Canada's National Implementation Strategy on Climate Change. The objective of the report is to help Ontario decide if it should support a national strategy and/or ratify the Kyoto Protocol. Potential ways to meet the Kyoto commitments were also identified in the report. The study was based on an analysis of large amounts of data and information regarding the economic and technological aspects that affect the food and beverage processing industry in Ontario, including the seven major sub-sectors, located mostly in southern Ontario. The types of plants and their associated processes and fuel use were assessed to determine the size and nature of fuel use and greenhouse gas emissions for each sub-sector. The study examined end uses and base technologies for each sub-sector and compared them with energy efficient technologies and opportunities within the industry. Barriers, and how to overcome them, were also described. Ontario's results were then compared with results from Canada's Foundation Paper and Options Analysis prepared for the Agriculture and Agri-Food Table on Climate Change. It was determined that the primary source of greenhouse gases for the industry comes from the use of energy directly from the combustion of fossil fuels and indirectly from the use of electricity. The contributions to greenhouse gases through chlorofluorocarbons or through waste stream is small and shrinking. It was concluded that mitigation strategies should concentrate on energy conservation through energy

  8. Current and future treatment options in osteoporosis.

    LENUS (Irish Health Repository)

    Brewer, Linda

    2012-02-01

    PURPOSE: The incidence of osteoporosis-related fractures will increase substantially over the coming decades as the population ages globally. This has important economic and public health implications, contributing substantially to morbidity and excess mortality in this population. METHODS: When prescribing for older patients the effectiveness profile of drugs needs to be balanced against their tolerability in individual patients. RESULTS: Currently we have good anti-fracture data to support the use of many available anti-resorptive and anabolic drugs including bisphosphonates, strontium ranelate and recombinant human parathyroid hormone. We also have evidence to demonstrate the importance of calcium and vitamin D repletion in these patients. However, in recent years our understanding of normal bone physiology and the mechanisms underlying the development of osteoporosis has significantly advanced and this has led to the development of new therapies. Novel agents, particularly denosumab, but also inhibitors of cathepsin K and anabolic agents that act on Wnt signalling, will increase the therapeutic options for clinicians in the coming years. CONCLUSION: This review discusses the evidence supporting the use of currently available treatment options for osteoporosis and potential future advances in drug therapy. Particular consideration should be given when prescribing for certain older patients who have issues with compliance or tolerance and also in those with co-morbidities or levels of frailty that may restrict the choice of therapy. Understanding the evidence for the benefit and possible harm of osteoporosis treatments is critical to appropriate management of this patient population.

  9. Biophysical stimuli as potentialtreatment for osteoporosis

    NARCIS (Netherlands)

    O.P. van der Jagt (Olav)

    2012-01-01

    textabstractOsteoporosis is a disease characterized by diminished bone mass and deterioration of the bone microarchitecture leading to a higher susceptibility for fractures. The best known ‘osteoporotic fractures’ are those of the hip and vertebrae because these fractures have the most detrimental

  10. Emerging therapies for the treatment of osteoporosis

    Directory of Open Access Journals (Sweden)

    Garima Bhutani

    2013-01-01

    Full Text Available Osteoporosis is a chronic disease of the osseous system characterized by decreased bone strength and increased fracture risk. It is due to an imbalance in the dynamic ongoing processes of bone formation and bone resorption. Currently available osteoporosis therapies like bisphosphonates, selective estrogen receptor modulators (SERMs, and denosumab are anti-resorptive agents. Parathyroid hormone analogs like teriparatide are the only anabolic agents currently approved for osteoporosis treatment. The side-effects and limited efficacy of the presently available therapies has encouraged extensive research into the pathophysiology of the disease and newer drug targets for its treatment. The novel anti-resorptive agents being developed are newer SERMs, osteoprotegerin, c-src (cellular-sarcoma kinase inhibitors, αVβ3 integrin antagonists, cathepsin K inhibitors, chloride channel inhibitors, and nitrates. Upcoming anabolic agents include calcilytics, antibodies against sclerostin and Dickkopf-1, statins, matrix extracellular phosphoglycoprotein fragments activin inhibitiors, and endo-cannabinoid agonists. Many of these new drugs are still in development. This article provides an insight into the emerging drugs for the treatment of osteoporosis.

  11. Osteoporosis Risk Factors in Eighth Grade Students.

    Science.gov (United States)

    Lysen, Victoria C.; Walker, Robert

    1997-01-01

    Presents findings from food frequency questionnaires and surveys of 138 Midwestern eighth-grade student-parent pairs. The study examined the incidence of modifiable and nonmodifiable osteoporosis risk factors and compared gender differences. Data analysis indicated that many adolescents possessed several modifiable and nonmodifiable risk factors…

  12. Preventing Osteoporosis in Postmenopausal Women: Treatment ...

    African Journals Online (AJOL)

    Osteoporosis is defined as a systemic skeletal disorder that reduces the strength of bone, resulting in an increased risk of fracture. Fractures occur, even if an individual is subjected to minimal trauma such as a fall from own body height. The most common osteoporotic fractures are fractures of the vertebrae, femur neck and ...

  13. Strontium ranelate in the treatment of osteoporosis

    African Journals Online (AJOL)

    2006-11-05

    Nov 5, 2006 ... postmenopausal women (mean age 69 years) with osteoporosis or osteopenia. Strontium ranelate significantly decreased markers of bone resorption and increased biomarkers of formation. Spinal BMD increased by 14%, while vertebral fractures decreased by 49% within the first year, a reduction that was.

  14. Osteoarthritis and Osteoporosis: What Is the Overlap?

    NARCIS (Netherlands)

    Bultink, I.E.M.; Lems, W.F.

    2013-01-01

    Osteoarthritis (OA) and osteoporosis (OP) are highly prevalent health problems, associated with considerable morbidity. In the past, attention was focused on a supposed inverse relationship between OA and OP, since both disorders usually affect the elderly, but were regarded to rarely coexist in a

  15. Ontario emissions trading code : emission reduction credit creation, recording and transfer rules, rules for renewable energy projects and conservation projects, and rules for the operation of the Ontario Emissions Trading Registry

    International Nuclear Information System (INIS)

    2001-12-01

    Emissions trading has been an integral part of Ontario's air quality strategy since December 31, 2001. Ontario has adopted the 'cap, credit and trade' type of emissions trading system, a hybrid that takes the best features of pure 'cap-and-trade' and 'baseline-and-credit' type systems. It covers nitric oxide and sulphur dioxide. The Ontario Emissions Trading Code supplements Ontario Regulation 397/01 and sets out rules for renewable energy projects and conservation projects for which applications for emission allowances can be made. This Code describes the rules for the creation and transfer of emission reduction credits (ERCs). It also explains the rules for the operation of the registry that has been established to provide information to the public about the emissions trading program and records decisions about credit creation and credit and allowance retirement. 3 tabs

  16. Introducing Physician Assistants to Ontario

    Directory of Open Access Journals (Sweden)

    Meredith Vanstone

    2014-02-01

    Full Text Available In 2006, the Ontario Ministry of Health and Long-Term Care (MOHLTC introduced Physician Assistants (PAs through the announcement of demonstration projects, education and training programs, and subsequent funding. PAs are directly supervised by physicians and act as physician extenders by performing acts as delegated to them by their supervising physicians. PAs were proposed as a potential solution to help improve access to health care and reduce wait times throughout the province. Prior to the 2006 Ministry announcement, there was little public discussion regarding the acceptance of the PA role or its sustainability. Opposition from nursing and other groups emerged in response to the 2006 announcement and flared again when stakeholder comments were solicited in 2012 as part of the PA application for status as regulated health professionals. As a health reform, the introduction of PAs has neither succeeded nor failed. In 2013, the majority of PA funding continues to be provided by the MOHLTC, and it is unknown whether the PA role will be sustainable when the MOHTLC withdraws salary funding and health system employers must decide whether or not to continue employing PAs at their own expense.

  17. Ontario Hydro annual report, 1988

    International Nuclear Information System (INIS)

    1989-04-01

    Ontario continues a strong growth in electricity consumption; over the past five years consumption has risen an average of 5 percent a year. In 1988 consumption rose by 6.5 percent to 133.1 billion kilowatt-hours. Peak demand was 23 million kilowatts. The top priority for the 1990s will be improving the energy efficiency of customers and the operating efficiency of the Corporation, with a target saving of 4500 megawatts through demand management and energy efficiency by the year 2000. A new environmental division has been formed, as well as a division for non-utility generation. Safety is of particular importance to the Nuclear Generating Division; in all nuclear operations, after 143 million hours worked from 1955 to 1988, there has never been a work-related fatality or a detectable injury due to radiation. The average radiation dose per worker continues to decline and is now under 10 percent of the legal dose limit. Retubing of Pickering Nuclear Generating Station unit 2 has been completed. Retubing of unit 1 is under way, and work on units 3 and 4 has been approved. Construction continues on the Darlington Nuclear Generating Station, where the first unit is expected to go into service in 1989. The Darlington Tritium Removal Facility was completed

  18. Insight conference proceedings : Ontario energy contracts 2005 : giving your company's energy trading the power it needs

    International Nuclear Information System (INIS)

    2005-01-01

    This conference provided a forum for discussing energy contracts in relation to energy trading. Issues concerning fixed priced electricity contracts and recent changes in the energy market were reviewed. Price procurement and interjurisdictional trading were examined. The role of the Independent Electricity System Operator (IESO) in the monitoring and procurement of energy contracts was evaluated. Various procurement strategies were discussed with reference to large institutions and industrial consumers. New regulatory developments relating to energy contracts in Ontario were reviewed and the emergence of demand side management as a commodity in the Ontario electricity market was discussed. Recent developments in the United States were examined in relation to Ontario's electricity sector. The conference featured 14 presentations, of which 1 has been catalogued separately for inclusion in this database. tabs., figs

  19. Osteoporosis in the Women's Health Initiative: Another Treatment Gap?

    Science.gov (United States)

    Sattari, Maryam; Cauley, Jane A; Garvan, Cynthia; Johnson, Karen C; LaMonte, Michael J; Li, Wenjun; Limacher, Marian; Manini, Todd; Sarto, Gloria E; Sullivan, Shannon D; Wactawski-Wende, Jean; Beyth, Rebecca J

    2017-08-01

    Osteoporotic fractures are associated with high morbidity, mortality, and cost. We performed a post hoc analysis of the Women's Health Initiative (WHI) clinical trials data to assess osteoporosis treatment and identify participant characteristics associated with utilization of osteoporosis medication(s) after new diagnoses of osteoporosis or fracture. Information from visits prior to and immediately subsequent to the first fracture event or osteoporosis diagnosis were evaluated for medication use. A full logistic regression model was used to identify factors predictive of osteoporosis medication use after a fracture or a diagnosis of osteoporosis. The median length of follow-up from enrollment to the last WHI clinic visit for the study cohort was 13.9 years. Among the 13,990 women who reported new diagnoses of osteoporosis or fracture between enrollment and their final WHI visit, and also had medication data available, 21.6% reported taking an osteoporosis medication other than estrogen. Higher daily calcium intake, diagnosis of osteoporosis alone or both osteoporosis and fracture (compared with diagnosis of fracture alone), Asian or Pacific Islander race/ethnicity (compared with White/Caucasian), higher income, and hormone therapy use (past or present) were associated with significantly higher likelihood of osteoporosis pharmacotherapy. Women with Black/African American race/ethnicity (compared with White/Caucasian), body mass index ≥30 (compared with body mass index of 18.5-24.9), current tobacco use (compared with past use or lifetime nonusers), and history of arthritis were less likely to use osteoporosis treatment. Despite well-established treatment guidelines in postmenopausal women with osteoporosis or history of fractures, pharmacotherapy use was suboptimal in this study. Initiation of osteoporosis treatment after fragility fracture may represent an opportunity to improve later outcomes in these high-risk women. Specific attention needs to be paid to

  20. Ontario's new electricity market and the future of OPG

    International Nuclear Information System (INIS)

    Howes, H.

    2002-01-01

    The recent measures taken by Ontario Power Generation since 1998 to deregulate the electricity market in the province of Ontario are reviewed. The opening of Ontario's power market in May 2002 will oblige Ontario Power Generation to reduce its market share. The author reviewed the current status of the energy market in Ontario and noted a modest growth in demand. A significant portion of the energy supply is being provided by nuclear, fossil fuels and hydro energy. The challenge facing Ontario Power Generation is to stay competitive in the new deregulated market and to participate in the energy market in the United States. 6 figs

  1. Ontario hydro's aqueous discharge monitoring program

    International Nuclear Information System (INIS)

    Mehdi, S.H.; Booth, M.R.; Massey, R.; Herrmann, O.

    1992-01-01

    The Province of Ontario has legislated a comprehensive monitoring program for waterborne trace contaminants called MISA - Municipal Industrial Strategy for Abatement. The electric power sector regulation applies to all generating stations (Thermal, Nuclear, Hydraulic). The program commenced in June, 1990. The current phase of the regulation requires the operators of the plants to measure the detailed composition of the direct discharges to water for a one year period. Samples are to be taken from about 350 identified streams at frequencies varying from continuous and daily to quarterly. The data from this program will be used to determine the scope of the ongoing monitoring program and control. This paper discusses the preparation and planning, commissioning, training and early operations phase of the MISA program. In response, the central Analytical Laboratory and Environmental staff worked to develop a sampling and analytical approach which uses the plant laboratories, the central analytical laboratory and a variety of external laboratories. The approach considered analytical frequency, sample stability, presence of radioactivity, suitability of staff, laboratory qualifications, need for long term internal capabilities, availability of equipment, difficulty of analysis, relationship to other work and problems, capital and operating costs. The complexity of the sampling program required the development of a computer based schedule to ensure that all required samples were taken as required with phase shifts between major sampling events at different plants to prevent swamping the capability of the central or external laboratories. New equipment has been purchased and installed at each plant to collect 24 hour composite samples. Analytical equipment has been purchased for each plant for analysis of perishable analytes or of samples requiring daily or thrice weekly analysis. Training programs and surveys have been implemented to assure production of valid data

  2. Understanding osteoporosis and fractures: an introduction to the use of qualitative research.

    Science.gov (United States)

    Hoang-Kim, A; Schemitsch, E; Sale, J E M; Beaton, D; Warmington, K; Kulkarni, A V; Reeves, S

    2014-02-01

    Qualitative research has been recognized in recent years as a field of inquiry used to understand people's beliefs, attitudes, behaviors, culture or lifestyle. While quantitative results are challenging to apply in everyday practice, the qualitative paradigm can be useful to fill in a research context that is poorly understood or ill-defined. It can provide an in-depth study of interactions, a way to incorporate context, and a means to hear the voices of participants. Understanding experiences, motivation, and beliefs can have a profound effect on the interpretation of quantitative research and generating hypotheses. In this paper, we will review different qualitative approaches that healthcare providers and researchers may find useful to implement in future study designs, specifically in the context of osteoporosis and fracture. We will provide insight into the qualitative paradigm gained from the osteoporosis literature on fractures using examples from the database Scopus. Five prominent qualitative techniques (narratives, phenomenology, grounded theory, ethnography, and case study) can be used to generate meanings of the social and clinical world. We have highlighted how these strategies are implemented in qualitative research on osteoporosis and fractures and are anchored to specific methodological practices. We focus on studies that explore patient psychosocial experiences of diagnosis and treatment, cultural boundaries, and interprofessional communication. After reviewing the research, we believe that action research, that is not frequently used, could also effectively be used by many professions to improve programs and policies affecting those dealing with osteoporosis issues.

  3. Meeting Ontario's electricity supply challenge

    International Nuclear Information System (INIS)

    Johnson, A.

    2004-01-01

    This paper presents a comparison between nuclear generation and other existing power generation, with particular reference to the natural gas industry. The aim of the paper was to present a rationale for an extensive nuclear restart in the near future in Ontario. An energy forecast was provided, generating capacity requirements were examined, with particular reference to requirements beyond conservation and renewable energy supplies. The cost effectiveness of nuclear rehabilitation was compared to combined cycle gas turbines (CCGT) in terms of capital and non-fuel costs. Future prospects of gas prices were discussed, as well as the possibilities of demand outstripping supply. CCGT costs were compared to nuclear rehabilitation in terms of overall electricity prices, including capital, non-fuel operating costs and fuel costs. Steps towards making the nuclear option a reality included a sustainable market environment; clear policy framework; a balanced energy mix; long term price certainty; and clear regulatory requirements. In was concluded that in order to regenerate its potential, the nuclear industry must demonstrate world class project management; fixed scope; fixed supplier prices; program commitment; guarantees; and realistic future production estimates. It was also concluded that nuclear restart and life extension was an extremely attractive option for consumers, offering long term stable competitive power, with fuel diversity and future reserves as well as zero greenhouse gas emissions and an optimization and use of existing facilities. Challenges in creating the right climate for nuclear rehabilitation were the difficulties in making the nuclear option attractive to investors as well as developing correct estimation of project times, costs, and scopes and allocation of project risks. tabs., figs

  4. Ontario Hydro 1982 annual report

    International Nuclear Information System (INIS)

    1983-05-01

    Due to the economic recession, primary electrical energy demand for the year failed to exceed that of the previous year for the first time since 1944. Actual demand was 100.8 billion kWh, 0.8 per cent below 1981. However, annual peak demand reached 18.1 million kW on January 18, an all-time high, and 5.4 per cent over January 1981. There were 104.1 billion kWh of electricity generated during the year, nearly equally from nuclear, coal, and water power. Nuclear generating units continued their outstanding performance. Bruce-3 completed a 494-day run at continuous power. NPD Generating Station celebrated 20 years of operation. Pickering B unit 5 started up and produced its first power. At Bruce A, a remote-controlled vehicle was used to remove damaged fuel to a shielded flask, completing the job in a short time with low staff radiation exposure. Bruce B construction progressed on schedule; while at Darlington, design and construction continued at a high level, with 1700 workers on site at year-end. Actual net income was $348 million, $38 million below forecast. Coal deliveries were 13.4 million Mg (23 per cent over 1981). Nuclear fuel deliveries to generating stations were 996 Mg (3 per cent over 1981). Agreements were negotiated for the supply of 5200 Mg of uranium concentrates during 1985-93. Nuclear fuel manufacturing contracts were awarded at lower prices than previously attained. Income totalling $163 million from electricity exports to the U.S.A. reduced overall cost of providing electricity to Ontario customers by 5.1 per cent. The Residential Energy Advisory Program surveyed 16,000 homeowners wishing to improve home energy efficiency. There were 20,000 residential customers who received grants to convert from oil to electric heating. Additional consumption resulting from these conversions is estimated at 280 million kWh

  5. Marketing program for R2000 in Ontario

    International Nuclear Information System (INIS)

    Killins, B.L.

    1990-01-01

    In the Ontario new housing market, Ontario Hydro's goal is to reduce the demand for electricity, increase the utility's visibility in this market, and increase customer satisfaction. Analyses have demonstrated that it costs less to construct new houses according to R-2000 insulation standards than to install new power production and transmission facilities. Research has also shown that R-2000 houses have better air quality and energy efficiency than ordinary houses. Nevertheless, most home builders have little enthusiasm for R-2000 houses; the strictness of airtightness standards, the slowness of certification, excessive paperwork, and a lack of promised marketing support are cited as the reasons for this. Ontario Hydro and builders' associations have signed a cooperative agreement for certifying new houses with the object of self-financing the program. The program intends to see construction of 1,000 R-2000 houses in 1990. To carry out this objective, some elements have been added to Ontario Hydro's marketing program in order to make potential customers aware of the advantages of the R-2000 house. Field staff will receive rigorous training in order to prepare them for helping the diverse types of builders. A mail campaign, focusing on areas not served by natural gas where significant numbers of new houses are being built, intends to bring home builders and buyers together. In February 1990, Ontario Hydro signed agreements with four major housing manufacturers to construct a significant proportion of the R-2000 housing stock

  6. Compliance and treatment satisfaction of post menopausal women treated for osteoporosis. Compliance with osteoporosis treatment

    Directory of Open Access Journals (Sweden)

    Huas Dominique

    2010-08-01

    Full Text Available Abstract Background Adherence to anti-osteoporosis treatments is poor, exposing treated women to increased fracture risk. Determinants of poor adherence are poorly understood. The study aims to determine physician- and patient- rated treatment compliance with osteoporosis treatments and to evaluate factors influencing compliance. Methods This was an observational, cross-sectional pharmacoepidemiological study with a randomly-selected sample of 420 GPs, 154 rheumatologists and 110 gynaecologists practicing in France. Investigators included post-menopausal women with a diagnosis of osteoporosis and a treatment initiated in the previous six months. Investigators completed a questionnaire on clinical features, treatments and medical history, and on patient compliance. Patients completed a questionnaire on sociodemographic features, lifestyle, attitudes and knowledge about osteoporosis, treatment compliance, treatment satisfaction and quality of life. Treatment compliance was evaluated with the Morisky Medication-taking Adherence Scale. Variables collected in the questionnaires were evaluated for association with compliance using multivariate logistic regression analysis. Results 785 women were evaluated. Physicians considered 95.4% of the sample to be compliant, but only 65.5% of women considered themselves compliant. The correlation between patient and physician perceptions of compliance was low (κ: 0.11 [95% CI: 0.06 to 0.16]. Patient-rated compliance was highest for monthly bisphosphonates (79.7% and lowest for hormone substitution therapy (50.0%. Six variables were associated with compliance: treatment administration frequency, perceptions of long-term treatment acceptability, perceptions of health consequences of osteoporosis, perceptions of knowledge about osteoporosis, exercise and mental quality of life. Conclusion Compliance to anti-osteoporosis treatments is poor. Reduction of dosing regimen frequency and patient education may be useful

  7. Development of a prototype clinical decision support tool for osteoporosis disease management: a qualitative study of focus groups

    Directory of Open Access Journals (Sweden)

    Newton David

    2010-07-01

    Full Text Available Abstract Background Osteoporosis affects over 200 million people worldwide, and represents a significant cost burden. Although guidelines are available for best practice in osteoporosis, evidence indicates that patients are not receiving appropriate diagnostic testing or treatment according to guidelines. The use of clinical decision support systems (CDSSs may be one solution because they can facilitate knowledge translation by providing high-quality evidence at the point of care. Findings from a systematic review of osteoporosis interventions and consultation with clinical and human factors engineering experts were used to develop a conceptual model of an osteoporosis tool. We conducted a qualitative study of focus groups to better understand physicians' perceptions of CDSSs and to transform the conceptual osteoporosis tool into a functional prototype that can support clinical decision making in osteoporosis disease management at the point of care. Methods The conceptual design of the osteoporosis tool was tested in 4 progressive focus groups with family physicians and general internists. An iterative strategy was used to qualitatively explore the experiences of physicians with CDSSs; and to find out what features, functions, and evidence should be included in a working prototype. Focus groups were conducted using a semi-structured interview guide using an iterative process where results of the first focus group informed changes to the questions for subsequent focus groups and to the conceptual tool design. Transcripts were transcribed verbatim and analyzed using grounded theory methodology. Results Of the 3 broad categories of themes that were identified, major barriers related to the accuracy and feasibility of extracting bone mineral density test results and medications from the risk assessment questionnaire; using an electronic input device such as a Tablet PC in the waiting room; and the importance of including well-balanced information in

  8. Lessons learned from Ontario wind energy disputes

    Science.gov (United States)

    Fast, Stewart; Mabee, Warren; Baxter, Jamie; Christidis, Tanya; Driver, Liz; Hill, Stephen; McMurtry, J. J.; Tomkow, Melody

    2016-02-01

    Issues concerning the social acceptance of wind energy are major challenges for policy-makers, communities and wind developers. They also impact the legitimacy of societal decisions to pursue wind energy. Here we set out to identify and assess the factors that lead to wind energy disputes in Ontario, Canada, a region of the world that has experienced a rapid increase in the development of wind energy. Based on our expertise as a group comprising social scientists, a community representative and a wind industry advocate engaged in the Ontario wind energy situation, we explore and suggest recommendations based on four key factors: socially mediated health concerns, the distribution of financial benefits, lack of meaningful engagement and failure to treat landscape concerns seriously. Ontario's recent change from a feed-in-tariff-based renewable electricity procurement process to a competitive bid process, albeit with more attention to community engagement, will only partially address these concerns.

  9. Assessing Ontario's Personal Support Worker Registry

    Directory of Open Access Journals (Sweden)

    Audrey Laporte

    2013-08-01

    Full Text Available In response to the growing role of personal support workers (PSWs in the delivery of health care services to Ontarians, the Ontario government has moved forward with the creation of a PSW registry. This registry will be mandatory for all PSWs employed by publicly funded health care employers, and has the stated objectives of better highlighting the work that PSWs do in Ontario, providing a platform for PSWs and employers to more easily access the labour market, and to provide government with information for human resources planning. In this paper we consider the factors that brought the creation of a PSW registry onto the Ontario government’s policy agenda, discuss how the registry is being implemented, and provide an analysis of the strengths and weaknesses of this policy change.

  10. Uranium and thorium deposits of Northern Ontario

    International Nuclear Information System (INIS)

    Robertson, J.A.; Gould, K.L.

    1983-01-01

    This, the second edition of the uranium-thorium deposit inventory, describes briefly the deposits of uranium and/or thorium in northern Ontario, which for the purposes of this circular is defined as that part of Ontario lying north and west of the Grenville Front. The most significant of the deposits described are fossil placers lying at or near the base of the Middle Precambrian Huronian Supergroup. These include the producing and past-producing mines of the Elliot Lake - Agnew Lake area. Also included are the pitchblende veins spatially associated with Late Precambrian (Keweenawan) diabase dikes of the Theano Point - Montreal River area. Miscellaneous Early Precambrian pegmatite, pitchblende-coffinite-sulphide occurrences near the Middle-Early Precambrian unconformity fringing the Lake Superior basin, and disseminations in diabase, granitic rocks, alkalic complexes and breccias scattered throughout northern Ontario make up the rest of the occurrences

  11. Awareness of osteoporosis in postmenopausal Indian women: An evaluation of Osteoporosis Health Belief Scale.

    Science.gov (United States)

    Gopinathan, Nirmal Raj; Sen, Ramesh Kumar; Behera, Prateek; Aggarwal, Sameer; Khandelwal, Niranjan; Sen, Mitali

    2016-01-01

    The level of awareness about osteoporosis in postmenopausal women who are the common sufferers. This study aims to evaluate the level of awareness in postmenopausal women using the Osteoporosis Health Belief Scale (OHBS). Osteoporosis has emerged as a common health problem in geriatric population. A proactive role needs to be played for preventing its consequences. Before initiating any preventive measures, an evaluation of awareness level of the target population is necessary. The questionnaire-based study design was used for this study. A questionnaire (OHBS)-based study in 100 postmenopausal women in Chandigarh was conducted. The bone mineral density (BMD) was measured in each case by dual energy X-ray absorptiometry. Height, weight, and body mass index (BMI) of the participants were noted. Statistical analysis was conducted to evaluate any correlation between the various components of the OHBS and the BMD. No statistically significant difference was noted in the seven component parameters of OHBS among the normal, osteopenic, and osteoporotic women suggesting that the health belief regarding susceptibility is not much different between the three groups of the study population. A statistically significant difference between the mean BMI of normal and osteoporotic population was noted. The results show that there is a great deficit in the awareness level of postmenopausal Indian women regarding osteoporosis. Most of the women were unaware of the condition and the means to prevent it. The study emphasizes that health care professionals have lot of ground to cover to decrease the incidence of osteoporosis and its associated health problem.

  12. Ontario feed-in-tariff programs

    International Nuclear Information System (INIS)

    Yatchew, Adonis; Baziliauskas, Andy

    2011-01-01

    Recent feed-in-tariff (FIT) programs in Ontario, Canada have elicited a very strong supply response. Within the first year of their inception, the Ontario Power Authority received applications totaling over 15,000 MW, equivalent to about 43% of current Ontario electricity generating capacity. The overwhelming share of applications is for wind-power (69%) and solar photovoltaic (28%) generating facilities. Wind generation is being remunerated at 14-19 cents /kWh. Solar facilities receive from 40 to 80 cents /kWh. The initiative, which responds to Provincial legislation is administratively divided into applications for facilities exceeding 10 kW (the FIT program) and those less than or equal to 10 kW (the microFIT program). This paper describes the programs and their features, compares them to their predecessors in Ontario as well as to programs elsewhere, analyses the reasons for the very strong response, and assesses their efficacy and sustainability. - Research highlights: → Recent feed-in-tariff (FIT) programs in Ontario, Canada have elicited a very strong supply response. Within the first year, applications totaled over 15,000 MW, equivalent to about 43% of current Ontario electricity generating capacity. → Most projects are either solar or wind. → Likely causes of strong supply response-preferred system access and favorable, secure tariffs. (Wind generation is being remunerated at 14-19 cents /kWh. Solar facilities receive from 40 to 80 cents /kWh.) → Long term political sustainability of present program is in question.

  13. The potential of solar PV in Ontario

    International Nuclear Information System (INIS)

    McMonagle, R.

    2005-01-01

    Canada has lagged behind other industrialized nations in the growth of solar energy markets. Currently, over 78 per cent of the global market for solar energy is for grid-connected applications where power is fed into the electrical distribution network. Less than 3.5 per cent of the Canadian solar market is grid-connected. This report investigated the potential size of the photovoltaic (PV) market in Ontario given adequate support from both governments and utilities. The forecast was based on sustainable growth levels that the solar industry as a whole might maintain over an extended period of time. It was suggested that it is technically feasible to install over 3000 MW of PV in single, detached homes in the province, which could generate over 3200 GWh each year. If the right policy conditions were put in place, the technical potential for PV on all buildings in Ontario is over 14,000 MW by 2025, which would generate over 13,000 GWh annually. Support mechanisms such as the Advanced Renewable Tariff (ART) or Standard Offer Contracts (SOC) will enable the PV industry to build capacity. Future markets for PV include new homes, commercial buildings and the existing housing stock. With a properly designed system, it is forecasted that the deployment of PV by 2025 could result in the involvement of 400,000 homes with over 1200 MW of installed capacity and over 290 MW installed annually by 2025. Recommendations to Ontario Power Authority's (OPA) report supply mix report focused on the use of SOCs as the appropriate support mechanism to start building solar capacity in Ontario, as projections using SOCs would see Ontario following the growth patterns of other nations. It was concluded that the OPA report does not acknowledge the current growth rates of PV globally, nor does it fully consider the potential of PV in Ontario. 9 refs., 8 figs

  14. Lived Experiences of “Silent” Osteoporosis

    DEFF Research Database (Denmark)

    Hansen, Carrinna; Konradsen, Hanne; Abrahamsen, Bo

    with osteoporosis and in prophylactic treatment were included. Data was obtained using individual interviews three times during one year. Data were analyzed at three levels: Naive reading, structural analysis and critical interpretation and discussion. Results The preliminary findings indicate that there are three...... categories of lived experiences of osteoporosis. 1) Accepting the diagnosis and embracing the medical treatment. 2) Seeking knowledge about the disease and the medication during embracing. 3) Alarmed by the diagnosis and of any adverse effect of the medication. Scientific and applicative relevance...... The project provides new basic research to be used in the efforts to enhance patient participation and to provide health professionals improved opportunities to support, guide and inform the individual patient....

  15. Osteoporose e gravidez Osteoporosis and pregnancy

    Directory of Open Access Journals (Sweden)

    Francisco Airton Castro da Rocha

    2005-06-01

    Full Text Available Os autores revisam a literatura sobre os possíveis efeitos da gravidez no desencadeamento de osteoporose, juntamente com uma breve discussão de aspectos da regulação do metabolismo do cálcio na mulher grávida. A carência de estudos a esse respeito é ressaltada. Os autores enfatizam a necessidade de estudos em nossa população, enfocando a possível associação entre paridade e fraturas decorrentes de osteoporose.The authors review the literature approaching the possible effects of pregnancy in the development of osteoporosis, coupled to a brief discussion of aspects about the regulation of calcium metabolism in pregnant women. The lack of studies focusing this subject is remarked. The authors emphasize the need for studies based on our population, approaching the possible association of parity and osteoporosis related fractures.

  16. [Pregnancy and lactation-associated osteoporosis].

    Science.gov (United States)

    Gehlen, M; Lazarescu, A D; Hinz, C; Boncu, B; Schmidt, N; Pfeifer, M; Schwarz-Eywill, M; Pollähne, W; Minne, H W

    2017-04-01

    Pregnancy and lactation-associated osteoporosis (PLO) is a rare form of osteoporosis, which occurs in the last trimester or postpartum. So far 100 cases have been published. The leading symptoms are severe low back pain or less frequently hip pain. Many patients develop postpartum depression due to inability to care for the baby and vertebral fractures. The therapeutic decision has to be made individually but teriparatid and bisphosphonates seem to be the best option. We report the clinical course (16 years) of a 37-year-old patient with PLO, who suffered 6 vertebral fractures. There were severe physical limitations and mental problems caused by the disease. The patient was treated by multimodal therapy including physiotherapy and psychotherapy and bisphosphonates were given. The time between the onset of symptoms and diagnosis was 5 months. No further fractures occurred in the following 16 years. The physical and mental condition significantly improved.

  17. Perceived risk of osteoporosis: Restricted physical activities?

    DEFF Research Database (Denmark)

    Reventlow, Susanne

    2007-01-01

    Objective. To explore elderly women's physical activity in relation to their perception of the risk of osteoporosis. Design. Qualitative study using in-depth interviews. Setting. Informants were purposely selected from a Danish population-based, age-specific cohort study conducted in the county...... of Copenhagen with people born in 1936. Subjects. Women in their sixties. Results. Women who perceived a current risk of osteoporosis tended to reduce their physical activity in an attempt to reduce the risk of bone damage. This behaviour was related to the imagined fragility of the bones (the risk inside...... the body), and the actual situations (the risk outside the body), including places and activities. Knowledge of a reduced bone mass reinforced the women's uncertainty about what their bones could endure. Experiences managing physical activity without injury resulted in reinterpretations of their risk...

  18. Osteoporosis and autophagy: What is the relationship?

    Directory of Open Access Journals (Sweden)

    Rinaldo Florencio-Silva

    Full Text Available Summary Autophagy is a survival pathway wherein non-functional proteins and organelles are degraded in lysosomes for recycling and energy production. Therefore, autophagy is fundamental for the maintenance of cell viability, acting as a quality control process that prevents the accumulation of unnecessary structures and oxidative stress. Increasing evidence has shown that autophagy dysfunction is related to several pathologies including neurodegenerative diseases and cancer. Moreover, recent studies have shown that autophagy plays an important role for the maintenance of bone homeostasis. For instance, in vitro and animal and human studies indicate that autophagy dysfunction in bone cells is associated with the onset of bone diseases such as osteoporosis. This review had the purpose of discussing the issue to confirm whether a relationship between autophagy dysfunction and osteoporosis exits.

  19. Application of reliability methods in Ontario Hydro

    International Nuclear Information System (INIS)

    Jeppesen, R.; Ravishankar, T.J.

    1985-01-01

    Ontario Hydro have established a reliability program in support of its substantial nuclear program. Application of the reliability program to achieve both production and safety goals is described. The value of such a reliability program is evident in the record of Ontario Hydro's operating nuclear stations. The factors which have contributed to the success of the reliability program are identified as line management's commitment to reliability; selective and judicious application of reliability methods; establishing performance goals and monitoring the in-service performance; and collection, distribution, review and utilization of performance information to facilitate cost-effective achievement of goals and improvements. (orig.)

  20. Is obesity in women protective against osteoporosis?

    OpenAIRE

    Migliaccio, Silvia; Greco, Emanuela A; Fornari, Rachele; Donini, Lorenzo M; Lenzi, Andrea

    2011-01-01

    Silvia Migliaccio1,2, Emanuela A Greco1, Rachele Fornari1, Lorenzo M Donini1, Andrea Lenzi11Dipartimento di Medicina Sperimentale, Sezione di Fisiopatologia, Endocrinologia e Nutrizione, Università Sapienza di Roma, 2Dipartimento di Scienze della Salute, Università Foro Italico di Roma, ItaliaAbstract: The belief that obesity is protective against osteoporosis has recently come into question. The latest epidemiologic and clinical studies have shown that a high level of f...

  1. Osteoporosis in haemophilia - an underestimated comorbidity?

    Science.gov (United States)

    Wallny, T A; Scholz, D T; Oldenburg, J; Nicolay, C; Ezziddin, S; Pennekamp, P H; Stoffel-Wagner, B; Kraft, C N

    2007-01-01

    A relationship between haemophilia and osteoporosis has been suggested, leading to the initiative for a larger study assessing this issue. Bone mineral density (BMD) was measured by osteodensitometry using dual energy X-ray absorptiometry (DEXA) in 62 male patients with severe haemophilia A; mean age 41 +/- 13.1 years, mean body mass index (BMI) 23.5 +/- 3.6 kg m(-2). Using the clinical score suggested by the World Federation of Hemophilia, all patients were assessed to determine the severity of their arthropathy. A reduced BMD defined as osteopenia and osteoporosis by World Health Organization criteria was detected in 27/62 (43.5%) and 16/62 (25.8%) patients, respectively. Fifty-five of sixty-two (88.7%) patients suffered from haemophilic arthropathy. An increased number of affected joints and/or an increased severity were associated with lower BMD in the neck of femur. Pronounced muscle atrophy and loss of joint movement were also associated with low BMD. Furthermore, hepatitis C, low BMI and age were found to be additional risk factors for reduced BMD in the haemophiliac. Our data shows that in haemophilic patients osteoporosis represents a frequent concomitant observation. The main cause for reduced bone mass in the haemophiliac is most probably the haemophilic arthropathy being typically associated with chronic pain and loss of joint function subsequently leading to inactivity. Further studies including control groups are necessary to elucidate the impact of comorbidities such as hepatitis C or HIV on the development of osteoporosis in the haemophiliac.

  2. Utilization of DXA Bone Mineral Densitometry in Ontario: An Evidence-Based Analysis.

    Science.gov (United States)

    2006-01-01

    Systematic reviews and analyses of administrative data were performed to determine the appropriate use of bone mineral density (BMD) assessments using dual energy x-ray absorptiometry (DXA), and the associated trends in wrist and hip fractures in Ontario. DUAL ENERGY X-RAY ABSORPTIOMETRY BONE MINERAL DENSITY ASSESSMENT: Dual energy x-ray absorptiometry bone densitometers measure bone density based on differential absorption of 2 x-ray beams by bone and soft tissues. It is the gold standard for detecting and diagnosing osteoporosis, a systemic disease characterized by low bone density and altered bone structure, resulting in low bone strength and increased risk of fractures. The test is fast (approximately 10 minutes) and accurate (exceeds 90% at the hip), with low radiation (1/3 to 1/5 of that from a chest x-ray). DXA densitometers are licensed as Class 3 medical devices in Canada. The World Health Organization has established criteria for osteoporosis and osteopenia based on DXA BMD measurements: osteoporosis is defined as a BMD that is >2.5 standard deviations below the mean BMD for normal young adults (i.e. T-score related fragility fractures occur most often in the wrist, femur and pelvis. These fractures, particularly those in the hip, are associated with increased mortality, and decreased functional capacity and quality of life. A Canadian study showed that at 1 year after a hip fracture, the mortality rate was 20%. Another 20% required institutional care, 40% were unable to walk independently, and there was lower health-related quality of life due to attributes such as pain, decreased mobility and decreased ability to self-care. The cost of osteoporosis and osteoporotic fractures in Canada was estimated to be $1.3 billion in 1993. With 2 exceptions, almost all guidelines address only women. None of the guidelines recommend blanket population-based BMD testing. Instead, all guidelines recommend BMD testing in people at risk of osteoporosis, predominantly

  3. Ontario's standard offer programs: moving toward a cleaner energy future

    International Nuclear Information System (INIS)

    Shervill, P.

    2006-01-01

    The Ontario Standard Offer Program is designed to ensure reliable, long-term electricity supply for Ontario. The functional areas of the program are planning, conservation and supply sector development. The long-term plan is to create a self-sustaining electricity market in Ontario with 2700 MW renewable sources by 2010 including wind, waterpower, solar photovoltaic (PV) and biomass

  4. "Strengthening" Ontario Universities: A Neoliberal Reconstruction of Higher Education

    Science.gov (United States)

    Rigas, Bob; Kuchapski, Renée

    2016-01-01

    This paper reviews neoliberalism as an ideology that has influenced higher education generally and Ontario higher education in particular. It includes a discourse analysis of "Strengthening Ontario's Centres of Creativity, Innovation and Knowledge" (Ontario Ministry of Training, Colleges, and Universities, 2012), a government discussion…

  5. Osteoporosis Syndrome in Thalassaemia Major: An Overview

    Directory of Open Access Journals (Sweden)

    Meropi Toumba

    2010-01-01

    Full Text Available Osteoporosis in thalassaemia major (TM represents a prominent cause of morbidity. The mechanism of pathogenesis of bone disease (BD in TM is multifactorial and complicated. Peak bone mass is achieved shortly after completion of puberty and normally remains stable until the third decade of life when age-related bone mass begins. Growth hormone (GH and sex steroids play a crucial role in bone remodeling and in the maintenance of skeletal architecture during adult life. GH and insulin growth factors (IGFs have anabolic effect in bone formation. Sex steroids act probably by increasing the expression of RANKL by osteoblastic cells and alterations in the RANK/RANKL/OPG system in favor of osteoclasts. Impaired GH secretion and lack of sex steroids in thalassemic patients due to pituitary damage, contribute to failure of achieving optimal peak bone mass. Other endocrine complications such as hypoparathyroidism and vitamin D deficiency have also a detrimental role on bones in TM. It is still questionable whether the international criteria for defining osteopenia and osteoporosis are relevant to patients with TM; also a question arises for the diagnostic methods such as DEXA scan and management of osteoporosis with known treatment protocols, in the thalassaemic patient.

  6. [Advances in the treatment of secondary osteoporosis].

    Science.gov (United States)

    Galindo Zavala, R; Núñez Cuadros, E; Díaz Cordovés-Rego, G; Urda Cardona, A L

    2014-12-01

    Osteoporosis is being increasingly recognised in paediatric practice as a consequence of the increasing life expectancy of children who suffer from chronic diseases and other factors. There are many non-pharmacological measures that can improve children' bone health, for example, avoiding inflammatory activity and osteotoxic treatments; increasing sun exposure and weight-bearing exercise, and maintaining an adequate nutritional status. Vitamin D and calcium supplements have been proposed as a measure to increase bone mass, but their effect and therapeutic indications are not completely clear. On the other hand, bisphosphonates are currently the only pharmacological alternative for the patients with infantile secondary osteoporosis. However, more studies are required on the therapeutic indications, posology, and long term secondary effects of biphosphonates. The aim of this article is to analyze the scientific evidence of the effectiveness of the therapeutic alternatives for childhood secondary osteoporosis and their safety in children. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  7. Animal models of osteoporosis - necessity and limitations

    Directory of Open Access Journals (Sweden)

    Turner A. Simon

    2001-06-01

    Full Text Available There is a great need to further characterise the available animal models for postmenopausal osteoporosis, for the understanding of the pathogenesis of the disease, investigation of new therapies (e.g. selective estrogen receptor modulators (SERMs and evaluation of prosthetic devices in osteoporotic bone. Animal models that have been used in the past include non-human primates, dogs, cats, rodents, rabbits, guinea pigs and minipigs, all of which have advantages and disadvantages. Sheep are a promising model for various reasons: they are docile, easy to handle and house, relatively inexpensive, available in large numbers, spontaneously ovulate, and the sheep's bones are large enough to evaluate orthopaedic implants. Most animal models have used females and osteoporosis in the male has been largely ignored. Recently, interest in development of appropriate prosthetic devices which would stimulate osseointegration into osteoporotic, appendicular, axial and mandibular bone has intensified. Augmentation of osteopenic lumbar vertebrae with bioactive ceramics (vertebroplasty is another area that will require testing in the appropriate animal model. Using experimental animal models for the study of these different facets of osteoporosis minimizes some of the difficulties associated with studying the disease in humans, namely time and behavioral variability among test subjects. New experimental drug therapies and orthopaedic implants can potentially be tested on large numbers of animals subjected to a level of experimental control impossible in human clinical research.

  8. The Critical Role of Estrogen in Menopausal Osteoporosis

    Directory of Open Access Journals (Sweden)

    Mrinali Sharma

    2017-12-01

    Full Text Available Osteoporosis is a bone disorder, which causes a reduction in the mass and density of bone tissue, and implants a greater possibility for skeletal fractures to occur. This bone disease is especially relevant for women suffering from menopause. Due to this general prevalence, osteoporosis requires continual intervention in the pharmacological and medicinal industry for better treatment alternatives for patients. A focal point for many scientific research studies for osteoporosis has been estrogen. As a hormone, estrogen exhibits a fluctuating capacity in the woman's body, and this has been proclaimed to be a qualifying explanation as to why women develop osteoporosis after menopause. The purpose of this paper is to interpret estrogen's capacity to treat menopausal osteoporosis. Thus, in this article, estrogen’s significance in bone health and different forms, derivatives, and the combinations of estrogen is examined in terms of efficiency in treating osteoporosis. [J Contemp Med 2017; 7(4.000: 418-427

  9. Aberrant tryptophan transport in cultured fibroblast from patients with Male Idiopathic Osteoporosis: An in vitro study

    Directory of Open Access Journals (Sweden)

    Ylva Pernow

    2018-06-01

    Full Text Available It has been demonstrated, that long-term chronic tryptophan deficiency, results in decreased serotonin synthesis, which may lead to low bone mass and low bone formation. Findings from studies in male patients with idiopathic osteoporosis suggested a decreased transport of tryptophan in erythrocytes of osteoporotic patients, indicating that serotonin system defects may be involved in the etiology of low bone mass. Tryptophan is the precursor of serotonin, and a disturbed transport of tryptophan is implicated in altered serotonin synthesis. However, no study has investigated the tryptophan transport kinetics in MIO patients. The aim of this study is to investigate the kinetic parameters of tryptophan transport in fibroblasts derived from MIO patients compared to age and sex matched controls.Fibroblast cells were cultured from skin biopsies obtained from 14 patients diagnosed with Male Idiopathic Osteoporosis and from 13 healthy age-sex matched controls, without a diagnosis of osteoporosis. Transport of the amino acid tryptophan across the cell membrane was measured by the cluster tray method. The kinetic parameters, maximal transport capacity (Vmax and affinity constant (Km were determined by using the Lineweaver-Burke plot equation.The results of this study have shown a significantly lower mean value for Vmax (p=0.0138 and lower Km mean value (p=0.0009 of tryptophan transport in fibroblasts of MIO patients compared to the control group. A lower Vmax implied a decreased tryptophan transport availability in MIO patients.In conclusion, reduced cellular tryptophan availability in MIO patients might result in reduced brain serotonin synthesis and its endogenous levels in peripheral tissues, and this may contribute to low bone mass/formation. The findings of the present study could contribute to the etiology of idiopathic osteoporosis and for the development of novel approaches for diagnosis, treatment and management strategies of MIO. Keywords: Male

  10. Artificial intelligence on the identification of risk groups for osteoporosis, a general review.

    Science.gov (United States)

    Cruz, Agnaldo S; Lins, Hertz C; Medeiros, Ricardo V A; Filho, José M F; da Silva, Sandro G

    2018-01-29

    The goal of this paper is to present a critical review on the main systems that use artificial intelligence to identify groups at risk for osteoporosis or fractures. The systems considered for this study were those that fulfilled the following requirements: range of coverage in diagnosis, low cost and capability to identify more significant somatic factors. A bibliographic research was done in the databases, PubMed, IEEExplorer Latin American and Caribbean Center on Health Sciences Information (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science, and Science Direct searching the terms "Neural Network", "Osteoporosis Machine Learning" and "Osteoporosis Neural Network". Studies with titles not directly related to the research topic and older data that reported repeated strategies were excluded. The search was carried out with the descriptors in German, Spanish, French, Italian, Mandarin, Portuguese and English; but only studies written in English were found to meet the established criteria. Articles covering the period 2000-2017 were selected; however, articles prior to this period with great relevance were included in this study. Based on the collected research, it was identified that there are several methods in the use of artificial intelligence to help the screening of risk groups of osteoporosis or fractures. However, such systems were limited to a specific ethnic group, gender or age. For future research, new challenges are presented. It is necessary to develop research with the unification of different databases and grouping of the various attributes and clinical factors, in order to reach a greater comprehensiveness in the identification of risk groups of osteoporosis. For this purpose, the use of any predictive tool should be performed in different populations with greater participation of male patients and inclusion of a larger age range for the

  11. Osteoporosis with vertebral fractures associated with pregnancy: two case reports

    OpenAIRE

    Raffaetà, Gloria; Mazzantini, Maurizio; Menconi, Agnese; Bottai, Vanna; Falossi, Francesca; Celauro, Ilenia; Guido, Giulio

    2014-01-01

    Pregnancy and lactation-associated osteoporosis (PAO) is a rare condition characterized by the occurrence of fragility fractures, most commonly vertebral, in late pregnancy or the early postpartum period. The prevalence, etiology and pathogenesis of this osteoporosis are unknown, although there are several hypotheses attempting to explain the etiopathogenesis of pregnancy associated osteoporosis. In this paper we present two cases of young women who developed severe PAO with vertebral fractur...

  12. Osteoporosis Knowledge and Beliefs Among Jordanian Men at Karak City

    Directory of Open Access Journals (Sweden)

    Diala Altwalbeh

    2017-04-01

    Full Text Available Aim: Osteoporosis is a skeletal disorder in which the bones become weak, brittle, and more likely to break. This disease is excessively prevalent among women, but it may also affect the male individuals. There is a lack of studies, which have assessed men’s knowledge and beliefs in Jordan about osteoporosis. Thus, this study aims to explore the level of knowledge and health beliefs regarding osteoporosis among Jordanian men at Karak city. Method: A descriptive and cross-sectional study was conducted after recruiting 88 men, who attended a primary healthcare centre at Karak city. Men’s knowledge of osteoporosis was assessed using two instruments; “The Facts on Osteoporosis Quiz” and the “Male Osteoporosis Knowledge Quiz”. Osteoporosis health beliefs were assessed using the “Osteoporosis Health Belief Scale”. Results: Most of the selected participants reported that they have heard about osteoporosis before. The main source of osteoporosis information was mass media (43.18%, which was followed by family members or friends (25%. The studied sample scored a mean of 9.02 out of 26 with a range of 3 to 16, reflecting 34.70% of the maximum possible score. The selected participants had a low perceived susceptibility, moderate perceived seriousness, high perceived benefits of exercise and calcium intake, low perceived barriers to calcium intake compared to moderate perceived barrier to exercise, and moderate perceived health motivation. Conclusion: Educational interventions are required to increase men’s awareness about the seriousness of osteoporosis and its impact in later life. Healthcare providers should focus more on increased awareness level about osteoporosis.

  13. The burden of illness of osteoporosis in Canada.

    Science.gov (United States)

    Tarride, J-E; Hopkins, R B; Leslie, W D; Morin, S; Adachi, J D; Papaioannou, A; Bessette, L; Brown, J P; Goeree, R

    2012-11-01

    To update the 1993 burden of illness of osteoporosis in Canada, administrative and community data were used to calculate the 2010 costs of osteoporosis at $2.3 billion in Canada or 1.3% of Canada's healthcare expenditures. Prevention of fractures in high-risk individuals is key to decrease the financial burden of osteoporosis. Since the 1996 publication of the burden of osteoporosis in 1993 in Canada, the population has aged and the management of osteoporosis has changed. The study purpose was to estimate the current burden of illness due to osteoporosis in Canadians aged 50 and over. Analyses were conducted using five national administrative databases from the Canadian Institute for Health Information for the fiscal-year ending March 31 2008 (FY 2007/2008). Gaps in national data were supplemented by provincial and community data extrapolated to national levels. Osteoporosis-related fractures were identified using a combination of most responsible diagnosis at discharge and intervention codes. Fractures associated with severe trauma codes were excluded. Costs, expressed in 2010 dollars, were calculated for osteoporosis-related hospitalizations, emergency care, same day surgeries, rehabilitation, continuing care, homecare, long-term care, prescription drugs, physician visits, and productivity losses. Sensitivity analyses were conducted to measure the impact on the results of key assumptions. Osteoporosis-related fractures were responsible for 57,413 acute care admissions and 832,594 hospitalized days in FY 2007/2008. Acute care costs were estimated at $1.2 billion. When outpatient care, prescription drugs, and indirect costs were added, the overall yearly cost of osteoporosis was over $2.3 billion for the base case analysis and as much as $3.9 billion if a proportion of Canadians were assumed to be living in long-term care facilities due to osteoporosis. Osteoporosis is a chronic disease that affects a large segment of the adult population and results in a

  14. Surgical treatment of severe osteoporosis including new concept of advanced severe osteoporosis

    Directory of Open Access Journals (Sweden)

    Jin Hwan Kim

    2017-12-01

    Full Text Available Severe osteoporosis is classified as those with a bone mineral density (BMD T-score of −2.5 or lower, and demonstrate one or more of osteoporotic, low-trauma, fragility fractures. According to the general principle of surgical approach, patients with severe osteoporosis require not only more thorough pre- and postoperative treatment plans, but improvements in surgical fixtures and techniques such as the concept of a locking plate to prevent bone deformity and maximizing the blood flow to the fracture site by using a minimally invasive plate osteosynthesis. Arthroplasty is often performed in cases of displaced femoral neck fracture. Otherwise internal fixation for the goal of bone union is the generally accepted option for intertrochanteric, subtrochanteric, and femoral shaft fractures. Most of osteoporotic spine fracture is stable compression fracture, but vertebroplasty or kyphoplasty may be performed some selective patients. If neurological paralysis, severe spinal instability, or kyphotic deformity occurs, open decompression or fusion surgery may be considered. In order to overcome shortcomings of the World Health Organization definition of osteoporosis, we proposed a concept of ‘advanced severe osteoporosis,’ which is defined by the presence of proximal femur fragility fracture or two or more fragility fractures in addition to BMD T-score of −2.5 or less. In conclusion, we need more meticulous approach for surgical treatment of severe osteoporosis who had fragility fracture. In cases of advanced severe osteoporosis, we recommend more aggressive managements using parathyroid hormone and receptor activator of nuclear factor kappa-B ligand monoclonal antibody.

  15. Total quality culture in radiotherapy departments across Ontario

    International Nuclear Information System (INIS)

    Mitera, Gunita; Whitton, Anthony; Gutierrez, Eric; Robson, Sheila

    2011-01-01

    Purpose: To investigate the prevalence of total quality culture (TQC) within radiation therapy (RT) departments across Ontario, Canada. Methods: A prospective quantitative survey was distributed within RT departments across Ontario, Canada using the Miller Consulting Group Quality Culture survey. Findings: Ninety percent of managers (9/10) and 50% of employees (261/519) participated. There was concordance between managers and staff that overall RT departments exhibit a work culture that somewhat resembles TQC. Both groups scored 55% of the categories as somewhat agree with TQC and 9% of categories as no TQC. There was discordance in views for 36% of the categories, where managers scored a higher prevalence of TQC compared to their therapists. Larger RT departments (>50 employees) had more prevalence of discrepancy between group scores. Conclusions: This is the first study to report on the prevalence of TQC within RT departments. Strategies designed for on-going continuous improvement will benefit staff, RT managers, continuity of patient care and patient safety within RT departments.

  16. Smoke and mirrors: used oil management policy in Ontario

    International Nuclear Information System (INIS)

    Valiante, U.

    1997-01-01

    The burning of used oil for space heating is a practice that has been increasing since 1992 when the waste fuel regulation was amended to give northern generators without access to used oil collection an option for managing their used oil. In 1996, about 10 million litres of used oil was burned in Ontario at over 600 locations, in garages, automotive repair facilities, industrial locations and greenhouses. The modified space heaters that burn used motor oils operate without pollution controls. In addition to emissions associated with pollution from uncontrolled combustion, used oil fired space heaters burn what should be a reusable commodity that is high in value added chemical and energy content. A comparison of emissions in grams per 1000 hours of use of a used oil heater and a natural gas heater was presented. It was suggested that as the preferred environmental strategy, the Ontario government should encourage used oil collectors and re-refiners to make used oil management convenient, accessible, and cost-effective in order to protect the health of communities in which used oil is generated

  17. Differentiation of Bone Marrow Mesenchymal Stem Cells in Osteoblasts and Adipocytes and its Role in Treatment of Osteoporosis.

    Science.gov (United States)

    Wang, Cheng; Meng, Haoye; Wang, Xin; Zhao, Chenyang; Peng, Jing; Wang, Yu

    2016-01-21

    Osteoporosis is a systemic metabolic bone disorder characterized by a decrease in bone mass and degradation of the bone microstructure, leaving bones that are fragile and prone to fracture. Most osteoporosis treatments improve symptoms, but to date there is no quick and effective therapy. Bone marrow mesenchymal stem cells (BMMSCs) have pluripotent potential. In adults, BMMSCs differentiate mainly into osteoblasts and adipocytes in the skeleton. However, if this differentiation is unbalanced, it may lead to a decrease in bone mass. If the number of adipocyte cells increases and that of osteoblast cells decreases, osteoporosis can result. A variety of hormones and cytokines play an important role in the regulation of BMMSCs bidirectional differentiation. Therefore, a greater understanding of the regulation mechanism of BMMSC differentiation may provide new methods to prevent and treat osteoporosis. In addition, autologous, allogeneic BMMSCs or genetically modified BMMSC transplantation can effectively increase bone mass and density, increase bone mechanical strength, correct the imbalance in bone metabolism, and increase bone formation, and is expected to provide a new strategy and method for the treatment of osteoporosis.

  18. Osteomalacia and osteoporosis associated with primary intestinal lymphangiectasis.

    Science.gov (United States)

    Li, Xin-Ping; Shen, Wen-Bin; Long, Ming-Qing; Meng, Xun-Wu; Lian, Xiao-Lan; Yu, Miao

    2012-05-01

    Primary Intestinal lymphangiectasia (PIL) is a common cause of protein losing enteropathy (PLE). It will affect enter-hepatic circulation of lipid-soluble vitamin, and absorption of electrolytes, cause malnutrition related osteomalacia or osteoporosis. While seldom health care workers noted to assess and treat osteomalacia or osteoporosis in PIL. Here we report a related case. We found increased parathyroid hormone, decreased 25(OH)D3, low bone mineral density, which indicated that the PIL patient had osteomalacia and/or osteoporosis. Adequate calcium and vitamin D supply can relieve the condition efficaciously. We should pay attention to osteomalacia and osteoporosis in PIL patients.

  19. Clinical update of pulsed electromagnetic fields on osteoporosis

    Institute of Scientific and Technical Information of China (English)

    HUANG Li-qun; HE Hong-chen; HE Cheng-qi; CHEN Jian; YANG Lin

    2008-01-01

    Objective To understand the effects of low-frequency pulsed electromagnetic fields (PEMFs) on chronic bony pain,bone mineral density (BMD), bone strength and biochemical markers of bone metabolism in the patients of osteoporosis.Data sources Using the key words "pulsed electromagnetic fields" and "osteoporosis", we searched the PubMed for related studies published in English from January 1996 to December 2007. We also searched the China National Knowledge Infrastructure (CNKI) for studies published in Chinese from January 1996 to December 2007.Study selection Inclusion criteria: (1) all articles which referred to the effects of low-frequency pulsed magnetic fields on osteoporosis either in primary osteoporosis or secondary osteoporosis; (2) either observational studies or randomized controlled studies. Exclusion criteria: (1) articles on experimental studies about osteoporosis; (2) repetitive studies; (3)case reports; (4) meta analysis.Results Totally 111 related articles were collected, 101 of them were published in Chinese, 10 were in English.Thirty-four were included and the remaining 84 were excluded.Conclusions Low-frequency PEMFs relieves the pain of primary osteoporosis quickly and efficiently, enhances bone formation and increases BMD of secondary osteoporosis. But the effects of PEMFs on bone mineral density of primary osteoporosis and bone resorption were controversial.

  20. Ontario Hydro's plan for used nuclear fuel

    International Nuclear Information System (INIS)

    Stevens-Guille, P.D.; Howes, H.A.; Freire-Canosa, J.

    1992-01-01

    A comprehensive plan for the management of used nuclear fuel has been published by Ontario Hydro. In this paper current practices are discussed and actions leading to disposal in a repository are outlined. Extended storage options are discussed should disposal be delayed

  1. Measuring Social Capital in Hamilton, Ontario

    Science.gov (United States)

    Kitchen, Peter; Williams, Allison; Simone, Dylan

    2012-01-01

    Social capital has been studied by academics for more than 20 years and within the past decade there has been an explosion of growth in research linking social capital to health. This paper investigates social capital in Hamilton, Ontario by way of a telephone survey of 1,002 households in three neighbourhood groups representing high, mixed and…

  2. Poster - 27: Incident Learning Practices in Ontario

    Energy Technology Data Exchange (ETDEWEB)

    Angers, Crystal; Medlam, Gaylene; Liszewski, Brian; Simniceanu, Carina [The Ottawa Hospital Cancer Centre, Mississauga Halton/Central West Regional Cancer Center, Odette Cancer Centre, Cancer Care Ontario (Canada)

    2016-08-15

    Purpose: The Radiation Incident and Safety Committee (RISC), established and supported by Cancer Care Ontario (CCO), is responsible for advising the Provincial Head of the Radiation Treatment program on matters relating to provincial reporting of radiation incidents with the goal of improved risk mitigation. Methods: The committee is made up of Radiation Incident Leads (RILs) with representation from each of the 14 radiation medicine programs in the province. RISC routinely meets to review recent critical incidents and to discuss provincial reporting processes and future directions of the committee. Regular face to face meetings have provided an excellent venue for sharing incident learning practices. A summary of the incident learning practices across Ontario has been compiled. Results: Almost all programs in Ontario employ an incident learning committee to review incidents and identify corrective actions or process improvements. Tools used for incident reporting include: paper based reporting, a number of different commercial products and software solutions developed in-house. A wide range of classification schema (data taxonomies) are employed, although most have been influenced by national guidance documents. The majority of clinics perform root cause analyses but utilized methodologies vary significantly. Conclusions: Most programs in Ontario employ a committee approach to incident learning. However, the reporting tools and taxonomies in use vary greatly which represents a significant challenge to provincial reporting. RISC is preparing to adopt the National System for Incident Reporting – Radiation Therapy (NSIR-RT) which will standardize incident reporting and facilitate data analyses aimed at identifying targeted improvement initiatives.

  3. Ontario's Quality Assurance Framework: A Critical Response

    Science.gov (United States)

    Heap, James

    2013-01-01

    Ontario's Quality Assurance Framework (QAF) is reviewed and found not to meet all five criteria proposed for a strong quality assurance system focused on student learning. The QAF requires a statement of student learning outcomes and a method and means of assessing those outcomes, but it does not require that data on achievement of intended…

  4. The Status of Benthos in Lake Ontario

    Science.gov (United States)

    The benthic community of Lake Ontario was dominated by an amphipod (Diporeia spp.) prior to the 1990’s. Two dreissenid mussel species D. polymorpha (zebra) and D. bugensis (quagga) were introduced in 1989 and 1991 via ballast water exchange. D. bugensis was observed as deep as 85...

  5. Seven steps to an energy efficient Ontario

    International Nuclear Information System (INIS)

    2003-01-01

    The future of the electricity market in Ontario is examined in light of the recent debate concerning deregulation. This report focuses on measures that would have to be taken to ensure that there will be sufficient electricity available to serve the needs of Ontario. Increasing supply, or decreasing demand are discussed as the obvious answers to the problem at hand. The report concludes that: (1) mechanisms to encourage Demand Side Management and Demand Response have all but disappeared since the opening of the competitive electricity market in Ontario, (2) the current market structure does nothing to stimulate increased supply, nor does it encourage measures to reduce demand; as such, the result is an unsustainable situation. The report further concludes that Demand Side Management and Demand Response programs are essential components of the success of Ontario's evolving electricity market, and recommends programs that are designed and implemented in a manner that dovetail with parallel policies dealing with supply challenges. Seven essential elements of such a policy are discussed. These are: (1) vision and a clear set of goals for demand side management; (2) appropriate market drivers, principles and pricing incentives; (3) a central co-ordinating authority for managing demand side management; (4) appropriate implementation agents to manage programs and processes; (5) incentives to motivate change; (6) widespread education of the market; and (7) appropriate tactics to enable demand side management in sectors

  6. Poster - 27: Incident Learning Practices in Ontario

    International Nuclear Information System (INIS)

    Angers, Crystal; Medlam, Gaylene; Liszewski, Brian; Simniceanu, Carina

    2016-01-01

    Purpose: The Radiation Incident and Safety Committee (RISC), established and supported by Cancer Care Ontario (CCO), is responsible for advising the Provincial Head of the Radiation Treatment program on matters relating to provincial reporting of radiation incidents with the goal of improved risk mitigation. Methods: The committee is made up of Radiation Incident Leads (RILs) with representation from each of the 14 radiation medicine programs in the province. RISC routinely meets to review recent critical incidents and to discuss provincial reporting processes and future directions of the committee. Regular face to face meetings have provided an excellent venue for sharing incident learning practices. A summary of the incident learning practices across Ontario has been compiled. Results: Almost all programs in Ontario employ an incident learning committee to review incidents and identify corrective actions or process improvements. Tools used for incident reporting include: paper based reporting, a number of different commercial products and software solutions developed in-house. A wide range of classification schema (data taxonomies) are employed, although most have been influenced by national guidance documents. The majority of clinics perform root cause analyses but utilized methodologies vary significantly. Conclusions: Most programs in Ontario employ a committee approach to incident learning. However, the reporting tools and taxonomies in use vary greatly which represents a significant challenge to provincial reporting. RISC is preparing to adopt the National System for Incident Reporting – Radiation Therapy (NSIR-RT) which will standardize incident reporting and facilitate data analyses aimed at identifying targeted improvement initiatives.

  7. Ontario's emergency department process improvement program: the experience of implementation.

    Science.gov (United States)

    Rotteau, Leahora; Webster, Fiona; Salkeld, Erin; Hellings, Chelsea; Guttmann, Astrid; Vermeulen, Marian J; Bell, Robert S; Zwarenstein, Merrick; Rowe, Brian H; Nigam, Amit; Schull, Michael J

    2015-06-01

    In recent years, Lean manufacturing principles have been applied to health care quality improvement efforts to improve wait times. In Ontario, an emergency department (ED) process improvement program based on Lean principles was introduced by the Ministry of Health and Long-Term Care as part of a strategy to reduce ED length of stay (LOS) and to improve patient flow. This article aims to describe the hospital-based teams' experiences during the ED process improvement program implementation and the teams' perceptions of the key factors that influenced the program's success or failure. A qualitative evaluation was conducted based on semistructured interviews with hospital implementation team members, such as team leads, medical leads, and executive sponsors, at 10 purposively selected hospitals in Ontario, Canada. Sites were selected based, in part, on their changes in median ED LOS following the implementation period. A thematic framework approach as used for interviews, and a standard thematic coding framework was developed. Twenty-four interviews were coded and analyzed. The results are organized according to participants' experience and are grouped into four themes that were identified as significantly affecting the implementation experience: local contextual factors, relationship between improvement team and support players, staff engagement, and success and sustainability. The results demonstrate the importance of the context of implementation, establishing strong relationships and communication strategies, and preparing for implementation and sustainability prior to the start of the project. Several key factors were identified as important to the success of the program, such as preparing for implementation, ensuring strong executive support, creation of implementation teams based on the tasks and outcomes of the initiative, and using multiple communication strategies throughout the implementation process. Explicit incorporation of these factors into the

  8. Renewables without limits : moving Ontario to advanced renewable tariffs by updating Ontario's groundbreaking standard offer program

    International Nuclear Information System (INIS)

    Gipe, P.

    2007-11-01

    The Ontario Sustainable Energy Association (OSEA) promotes the development of community-owned renewable energy generation. It was emphasized that in order to achieve OSEA's original objectives of developing as much renewable energy as quickly as possible through community participation, changes are needed to Ontario's groundbreaking standard offer contract (SOC) program. This report examined the status of Ontario's SOC program and proposed changes to the program as part of the program's first two-year review. The report provided a summary of the program and discussed each of the program's goals, notably to encourage broad participation; eliminate barriers to distributed renewable generation; provide a stable market for renewable generation; stimulate new investment in renewable generation; provide a rigorous pricing model for setting the tariffs; create a program applicable to all renewable technologies; provide a simple, streamlined, and cost-effective application process; and provide a dispute resolution process. The program goals as developed by the Ontario Power Authority and Ontario Energy Board were discussed with reference to mixed results to date; simplicity; removing barriers; balancing targets with value to ratepayers; and building on the efforts of OSEA. Advanced renewable tariffs (ART) and tariff determination was also discussed along with ART's in Germany, France, Spain and Ontario. Inflation indexing; tariff degression; proposed new tariffs by technology; and other costs and factors affecting profitability were also reviewed. ref., tabs

  9. Ontario's Clean Air Action Plan : protecting environmental and human health in Ontario

    International Nuclear Information System (INIS)

    2004-01-01

    Ontario's Clean Air Action Plan was launched in June 2000 in an effort to improve air quality and comply with the Canada-Wide Standards for Particulate Matter and Ozone. This paper describes Ontario's approach to reducing smog. Smog-related air pollution is linked to health problems such as premature death, respiratory and heart problems. Smog also contributes to environmental problems such as damage to forests, agricultural crops and natural vegetation. The two main ingredients of smog are ground level ozone and particulate matter. In order to reduce the incidence of smog, the following four key smog-causing pollutants must be reduced: nitrogen oxides, volatile organic compounds, sulphur dioxide and particular matter. This paper includes the 2001 estimates for Ontario's emissions inventory along with Ontario's smog reduction targets. It was noted that approximately half of all smog in Ontario comes from sources in the midwestern United States. The province of Ontario is committed to replacing coal-fired power plants with cleaner sources of energy. It is also considering emission caps for key industrial sectors. The key players in reducing smog include municipalities, industry, individuals, the federal government and programs that reduce emissions in the United States. 3 figs., 8 tabs., 1 appendix

  10. Assessing the financial positions of Ontario`s new electricity companies

    Energy Technology Data Exchange (ETDEWEB)

    Connell, T. [Standard and Poor`s, Toronto, ON (Canada)

    1999-11-01

    This paper describes the methodology, including the criteria factors, comparable ratings and key credit issues used in assessing the financial positions of Ontario Power Generation Inc., and the Ontario Hydro Services Company. The rating criteria factors include both business factors (such as ownership structure, regulation, service area, operations, management, etc.,) and financial factors (e.g. financial policies and guidelines, recent financial performance, margin analysis, capital structure and borrowing plans, financial projections and sensitivities). Key credit issues include considerations of competitive dynamics, nuclear portfolio performance (for Genco), regulatory changes, cost control, capital spending program, retail business exposure, future financial performance. Comparisons are made with corresponding positions of comparable entities in Australia, Finland, New Zealand, the UK, and the USA. In the case of Ontario Power Generation Inc., the company is assessed to have significant advantages initially, but various uncertainties over the medium term warrant a more cautious view of the credit profile. For the Ontario Hydro Services Company the business risks appear to be low and moderate leverage entails a strong, stable credit profile. The overall assessment of the two companies is that while certain questions such as the workability and credibility of the new industry structure, the problem of stranded debt and questions about the liquidity of market participants remain unsolved, Ontario Power Generation Inc., and the Ontario Hydro Services Company ratings compare favorably with ratings of global industry peers.

  11. Deregulation experiences in Alberta and Ontario

    International Nuclear Information System (INIS)

    Axford, D.

    2003-01-01

    A brief introduction of Nexen Chemicals, one of the largest producers of sodium chlorate in the world, was offered, and a map displaying its locations throughout the world was displayed. Nexen is one of Canada's largest independent oil and gas producers, while Nexen Marketing is involved in the marketing of natural gas in North America. In January 2001, the deregulated market opened in Alberta. High natural gas prices, generation shortages, high prices in California and an upcoming provincial election all combined to complicate the situation. A high degree of volatility characterized the market. A chart displaying weekly average Alberta power and gas prices from Jan 2002 to 13 Oct 2002 was shown. In Ontario, the market opened in May 2002, and the demand growth rate was in the 1 to 2 per cent range. The author indicated that approximately 20 per cent of homeowners in Ontario have signed deals with retailers, contrary to Alberta where very few have done so. A similar chart displaying weekly average Ontario power prices was presented. The issues in Ontario are: consistency in policy, increase market transparency, transmission / distribution price flexibility, overall transmission / distribution to industrial consumers high, and increasing costs of the system operator. In Alberta, the issues are: government intent, congestion management issues, and billing settlement errors that continue. The opportunities offered by a deregulated market include process responsiveness which is rewarded, the ability to look in forward prices when prices fit margin requirement, and gives companies the opportunity to participate in the development of the market. Various charts were also displayed to further illustrate the market in both Alberta and Ontario. figs

  12. Customer Service in Ontario's Colleges

    Science.gov (United States)

    Keith, John

    2005-01-01

    No doubt there are detractors who cringe at the prospect of connecting the term customer service with an institution of higher education. Some may consider the term demeaning. However, given the college funding crisis and current economic climate, a quality customer service strategy is a prudent adjunct to any marketing activity undertaken. It is…

  13. Generation adequacy in Ontario : Essential updates on the state of generation capacity and the latest efforts to solve the supply crunch

    International Nuclear Information System (INIS)

    2004-01-01

    This 2-day comprehensive conference on 'Generation Adequacy in Ontario' provides information to answer questions on how the province's electricity market will change in the near to longer term and how to amend your business strategy to keep pace with the rapid changes taking place. Information from an outstanding faculty of industry leaders and experts on critical issues, including: Ontario's Energy Policy: what is changing and how will generation adequacy be impacted?; Current planning strategies being designed, coordinated and implemented to increase electricity supply in the province; Examining existing generation assets and the requirements for the future in order to increase supply; Importing power from surrounding jurisdictions: what are the opportunities and what are the challenges?; Incenting new generation by improving investor confidence in Ontario's electricity industry; Decommissioning coal-fired generation: how will this government initiative play out and what will replace these plants?; Green power alternatives: what role will they play in the future of Ontario's electricity industry?

  14. Detection and significance of serum insulin-like growth factor-1 in patients with type 2 diabetes, osteoporosis and type 2 diabetic osteoporosis

    Institute of Scientific and Technical Information of China (English)

    Yan-Rong Kang; Pei-Li Gu

    2016-01-01

    Objective:To investigate the content of insulin-like growth factor-1 (IGF-1) in serum and the relationship with type 2 diabetes, osteoporosis and type 2 diabetic osteoporosis.Methods:A total of 86 cases of patients with type 2 diabetes, 82 cases of patients with osteoporosis, 79 cases of patients with type 2 diabetic osteoporosis and 86 cases of healthy person were selected, the levels of IGF-1, diabetes related factors (fasting plasma c-peptide, FIN, HbA1c, GLU) and osteoporosis related factors (BMP, osteocalcin,β-CTx, P1NP, lumbar vertebra BMD) were detected, the relationship between the above indicators were compared with those of the disease.Results: In each group, content change of IGF-1 was not statistically significant; content changes of IGF-1, BMP and osteocalcin were control group>type 2 diabetes group>osteoporosis group>type 2 diabetic osteoporosis group. Diabetic osteoporosis enhanced the decrease of IGF-1 content. The contents ofβ-CTx and P1NP in osteoporosis group and diabetic osteoporosis group were similar, which were significantly lower than that in control group and type 2 diabetes group. The level of lumbar vertebra BMD in osteoporosis group and diabetic osteoporosis group were the lowest. Fasting plasma c-peptide in diabetes group and diabetic osteoporosis group were significantly lower than that in control group and osteoporosis group, and the content of fasting plasma c-peptide in diabetic osteoporosis group was the lowest. The contents of FIN, HbA1c and GLU in type 2 diabetes group and type 2 diabetic osteoporosis group were significantly higher than that in control group and osteoporosis group.Conclusion:IGF-1 was related with type 2 diabetes, osteoporosis and type 2 diabetic osteoporosis, and could offer help for predicting type 2 diabetes and osteoporosis in the future.

  15. Rabbiteye blueberry prevents osteoporosis in ovariectomized rats.

    Science.gov (United States)

    Li, Tao; Wu, Shou-Mian; Xu, Zhi-Yuan; Ou-Yang, Sheng

    2014-08-08

    It has been forecasted that the rabbiteye blueberry could inhibit osteoporosis. However, the inhibition and prevention of osteoporosis via rabbiteye blueberry are still elusive. This study was aim to evaluate the anti-osteoporosis effects of rabbiteye blueberry in ovariectomized rats. Thirty rats were randomly divided into three groups of ten rats each as follows: sham-operated group (SG), ovariectomized model control group (OMG), and ovariectomized rabbiteye blueberry treatment group (OBG). The blood mineral levels, the alkaline phosphatase (ALP) activity, and osteoprotegerin (OPG) level were determined. The expression analyses of type I collagen, integrin-β1, and focal adhesion kinase (FAK) were performed. Besides, the bone mineral density (BMD) and bone histomorphometry (BH) were measured. The ALP activity in SG and OBG was significantly lower than that in OMG. For the OPG level, the significant increase of OPG level in OBG was indicated compared with the other groups. The mRNA expression levels of type I collagen, integrin-β1, and FAK in OMG were significantly lower than those in other groups. The BMD in OMG were all significantly lower than those in SG and OBG. For BH, blueberry significantly improved the trabecular bone volume fraction, trabecular thickness, mean trabecular bone number, and bone formation rate, and decreased the trabecular separation, the percent of bone resorption perimeter, and mean osteoclast number in OBG compared with OMG. The rabbiteye blueberries had an effective inhibition in bone resorption, bone loss, and reduction of bone strength of ovariectomized rats and could improve the BMD, osteogenic activity, and trabecular bone structure.

  16. Medical staffing in Ontario neonatal intensive care units.

    Science.gov (United States)

    Paes, B; Mitchell, A; Hunsberger, M; Blatz, S; Watts, J; Dent, P; Sinclair, J; Southwell, D

    1989-06-01

    Advances in technology have improved the survival rates of infants of low birth weight. Increasing service commitments together with cutbacks in Canadian training positions have caused concerns about medical staffing in neonatal intensive care units (NICUs) in Ontario. To determine whether an imbalance exists between the supply of medical personnel and the demand for health care services, in July 1985 we surveyed the medical directors, head nurses and staff physicians of nine tertiary level NICUs and the directors of five postgraduate pediatric residency programs. On the basis of current guidelines recommending an ideal neonatologist:patient ratio of 1:6 (assuming an adequate number of support personnel) most of the NICUs were understaffed. Concern about the heavy work pattern and resulting lifestyle implications has made Canadian graduates reluctant to enter this subspecialty. We propose strategies to correct staffing shortages in the context of rapidly increasing workloads resulting from a continuing cutback of pediatric residency positions and restrictions on immigration of foreign trainees.

  17. [Ibandronate in the treatment of postmenopausal osteoporosis].

    Science.gov (United States)

    Lakatos, Péter

    2008-10-01

    Postmenopausal osteoporosis affects 7-10% of the population of developed countries. During the past decade, a number of new therapeutical modalities have been made available. Among these, bisphosphonates mean the mainstay of medical treatment. Ibandronate belongs to the amino-bisphosphonate group of these drugs. Amino-bisphosphonates act via the mevalonate metabolic pathway, thus, inhibiting protein prenylation. Several clinical studies have shown a significant reduction in the fracture risk of osteoporotic patients treated with ibandronate. This compound can be administered orally once a month or intravenously once in every 3 months. Longer dosing intervals stimulate patient compliance, and consequently increase efficacy and cost effectiveness.

  18. Osteoporosis education improves osteoporosis knowledge and dietary calcium: comparison of a 4 week and a one-session education course.

    Science.gov (United States)

    Laslett, Laura L; Lynch, Joan; Sullivan, Thomas R; McNeil, Julian D

    2011-08-01

    Education is ideal for osteoporosis because many risk factors are modifiable. However, the efficacy of shortened education courses compared to a standard 4 week course for improving osteoporosis knowledge and healthy behaviours is not known. This study aimed to assess whether education changed knowledge and healthy behaviours over 3 months of follow-up; and whether changes in these outcomes were different between participants receiving the different education courses. Adults aged ≥ 50 years presenting to Emergency with mild to moderate trauma fractures received either the Osteoporosis Prevention and Self-Management Course (OPSMC) (4 × 2.5 h) (n = 75) or a one-session course (1 × 2.5 h) (n = 71) in a non-randomised prospective study with single-blinded allocation. Participants completed questionnaires measuring osteoporosis knowledge, dietary calcium, physical activity, calcium and exercise self-efficacy, and osteoporosis medications at baseline and 3 months. Data were analysed using mixed models and GEE regression models. Osteoporosis knowledge and calcium from food (% of RDI) increased from baseline to 3 months in both groups (P osteoporosis medications increased between baseline and 3 months in the OPSMC group while decreasing in the one-session group (P = 0.039). There were no differences between the groups or over time in physical activity, calcium or exercise self-efficacy. Osteoporosis education (either the OPSMC or the one-session course) improved osteoporosis knowledge and calcium intake after 3 months. Participants attending the OPSMC maintained medication compliance. We were unable to determine other differences between the courses. This study confirms the value of osteoporosis education for improving osteoporosis knowledge. © 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.

  19. Osteoporosis in Aging: Protect Your Bones with Exercise

    Science.gov (United States)

    ... start getting screened for osteoporosis at age 65. Women younger than age 65 who are at high risk for fractures should also be screened. Men should ... in people with osteoporosis who are at high risk for having a ... bones is to prevent falling and occasions for fracture in the first place. ...

  20. A rational approach to the treatment of osteoporosis | Hough | South ...

    African Journals Online (AJOL)

    Osteoporosis is a common, costly and serious disease. The life-time risk of an osteoporotic fracture in Caucasian women approximates 50%. Epidemiologic fracture data in South Africa are limited, but the incidence of osteoporosis appears to be similar in white, Indian and mixed ancestry (Coloured) females. South African ...

  1. The Prevalence of Osteoporosis among Antenatal Clinic Attendees ...

    African Journals Online (AJOL)

    Introduction: Osteoporosis is a global public health problem characterized by reduction of bone mineral density (BMD). This study aimed to assess the prevalence of osteoporosis among antenatal clinic attendees in a rural Southeastern hospital. Material and Methods: This was a cross‑sectional study of booking. Antenatal ...

  2. Severity of menopausal symptoms and cardiovascular and osteoporosis risk factors.

    Science.gov (United States)

    Martínez Pérez, J A; Palacios, S; Chavida, F; Pérez, M

    2013-04-01

    To assess whether the severity of menopausal symptoms is related to increased cardiovascular and osteoporosis risk factors, and to determine whether women with more severe menopausal symptoms present a greater percentage of osteoporosis disease. This was a cross-sectional, descriptive study encompassing women aged 45-65 years in the whole Spanish territory. The study population sample was collected through random sampling. A total of 10 514 women were included. Their sociodemographic, medical history and lifestyle data were assessed by means of a survey. The Kupperman Index was used to assess the severity of menopausal symptoms. Bone mineral density was measured by the dual X-ray absorptiometry method. The prevalences of risk factors for osteoporosis and cardiovascular disease were 67.6% and 74.8%, respectively. Women with a higher intensity of symptoms also had a greater percentage of cardiovascular (p osteoporosis (p osteoporosis disease (p obesity (OR 2.23; 95% CI 1.55-2.91; p osteoporosis disease (OR 3.71; 95% CI 2.9-4.52; p osteoporosis disease risk factors and suffered more from osteoporosis disease compared to those who had milder or no menopausal symptoms.

  3. [High prevalence of osteoporosis in asymptomatic postmenopausal Mapuche women].

    Science.gov (United States)

    Ponce, Lucía; Larenas, Gladys; Riedemann, Pablo

    2002-12-01

    Genetic and environmental factors are responsible for variations in the frequency of osteoporosis. Prevalence of osteoporosis in Mapuche women (native Chileans) is unknown. To assess the prevalence and risk factors for osteoporosis in Mapuche women. A random sample of 95 asymptomatic postmenopausal Mapuche females, stratified by age, was studied. Women with diseases or medications that could interfere with calcium metabolism were excluded. Spine and femoral neck bone mass density was determined using a Lunar DPX Alpha densitometer. Seventeen percent of women had normal bone mineral density in both spine and femoral neck. In the spine, 25.3% had a normal bone mineral density, 17.9% had osteopenia and 56.8% had osteoporosis. In the femoral neck, 34.7% had a normal bone mineral density, 57.9% had osteopenia, and 7.4% had osteoporosis. There was a positive correlation between bone mineral density and body mass index. Women with more than one hour per day of physical activity, had a significantly lower proportion of osteopenia or osteoporosis. No association between bone mineral density and parity or calcium intake, was observed. There is a high prevalence of osteopenia and osteoporosis among Mapuche women. Osteoporosis was associated with low body mass index.

  4. An Increased Risk of Osteoporosis during Acquired Immunodeficiency Syndrome.

    Science.gov (United States)

    Annapoorna, N; Rao, G Venkateswara; Reddy, N S; Rambabu, P; Rao, K R S Samabasiva

    2004-01-01

    Osteoporosis is characterized by decreased bone mineral density and mechanistic imbalances of bone tissue that may result in reduced skeletal strength and an enhanced susceptibility to fractures. Osteoporosis in its most common form affects the elderly (both sexes) and all racial groups of human beings. Multiple environmental risk factors like acquired immune deficiency syndrome (AIDS) are believed to be one of the causes of osteoporosis. Recently a high incidence of osteoporosis has been observed in human immunodeficiency virus (HIV) infected individuals. The etiology of this occurrence in HIV infections is controversial. This problem seems to be more frequent in patients receiving potent antiretroviral therapy. In AIDS, the main suggested risk factors for the development of osteoporosis are use of protease inhibitors, longer duration of HIV infection, lower body weight before antiretroviral therapy, high viral load. Variations in serum parameters like osteocalcin, c-telopeptide, levels of elements like Calcium, Magnesium, Phosphorus, concentration of vitamin-D metabolites, lactate levels, bicarbonate concentrations, amount of alkaline phosphatase are demonstrated in the course of development of osteoporosis. OPG/RANKL/RANK system is final mediator of bone remodeling. Bone mineral density (BMD) test is of added value to assess the risk of osteoporosis in patients infected with AIDS. The biochemical markers also aid in this assessment. Clinical management mostly follows the lines of treatment of osteoporosis and osteopenia.

  5. Bone mineral mass and bone turnover parameters in osteoporosis

    NARCIS (Netherlands)

    R.J. Erdtsieck (Ronald)

    1996-01-01

    textabstractIn the past decades osteoporosis has been recognized as an important public health problem. Several causes for this problem can be pointed out. The most probable cause for the development of osteoporosis is the loss of ovarian function in women and the increasing age of people, thereby

  6. Benthic prey fish assessment, Lake Ontario 2013

    Science.gov (United States)

    Weidel, Brian C.; Walsh, Maureen; Connerton, Michael J.

    2014-01-01

    The 2013 benthic fish assessment was delayed and shortened as a result of the U.S. Government shutdown, however the assessment collected 51 of the 62 planned bottom trawls. Over the past 34 years, Slimy Sculpin abundance in Lake Ontario has fluctuated, but ultimately decreased by two orders of magnitude, with a substantial decline occurring in the past 10 years. The 2013 Slimy Sculpin mean bottom trawl catch density (0.001 ind.·m-2, s.d.= 0.0017, n = 52) and mean biomass density (0.015 g·m-2 , s.d.= 0.038, n = 52) were the lowest recorded in the 27 years of sampling using the original bottom trawl design. From 2011-2013, the Slimy Sculpin density and biomass density has decreased by approximately 50% each year. Spring bottom trawl catches illustrate Slimy Sculpin and Round Goby Neogobius melanostoma winter habitat overlaps for as much as 7 months out of a year, providing opportunities for competition and predation. Invasive species, salmonid piscivory, and declines in native benthic invertebrates are likely all important drivers of Slimy Sculpin population dynamics in Lake Ontario. Deepwater Sculpin Myoxocephalus thompsonii, considered rare or absent from Lake Ontario for 30 years, have generally increased over the past eight years. For the first time since they were caught in this assessment, Deepwater Sculpin density and biomass density estimates declined from the previous year. The 2013 abundance and density estimates for trawls covering the standard depths from 60m to 150m was 0.0001 fish per square meter and 0.0028 grams per square meter. In 2013, very few small (recruitment. Nonnative Round Gobies were first detected in the USGS/NYSDEC Lake Ontario spring Alewife assessment in 2002. Since that assessment, observations indicate their population has expanded and they are now found along the entire south shore of Lake Ontario, with the highest densities in U.S. waters just east of the Niagara River confluence. In the 2013 spring-based assessment, both the

  7. The effect of Islamic fasting in Ramadan on osteoporosis

    Directory of Open Access Journals (Sweden)

    Seyed Mohammad Amin Kormi

    2017-06-01

    Full Text Available Osteoporosis is considered as one of the most common diseases that women face after their menopause and is caused by both genetic and environmental factors.  Dipeptidyl peptidase 4 (DPP-4 gene is one of the important genetic factors contributing in osteoporosis which has a direct and very important relationship with fasting. Fasting is one of the alternatives proved to reduce the DPP-4 level and activate the Dipeptidyl peptidase 4 inhibitors and so, prevent osteoporosis. On the other hand, the circadian rhythm has a direct relationship with osteoporosis. This has been found by the biochemical markers, indicating that fasting at certain hours of the day, especially during those hours of the day which are recommended as part of the Muslim tradition, is very effective in reducing the effects of osteoporosis.

  8. Gastric and esophagus events before and during treatment of osteoporosis

    DEFF Research Database (Denmark)

    Vestergaard, Peter; Schwartz, Kristoffer; Pinholt, Else Marie

    2009-01-01

    in patients on a wide range of drugs against osteoporosis both before and after initiation of these drugs. We studied a nationwide register-based cohort from Denmark with all users of drugs against osteoporosis between 1996 and 2006 (n = 103,562) as cases and three age- and sex-matched controls from...... against osteoporosis are associated with an increased risk of esophagitis, esophageal ulcers, esophageal perforation, and gastroduodenal ulcers. However, the increase was already present before initiation of the drug for several types of drugs against osteoporosis. This points at an effect...... of the underlying condition being treated or comorbid conditions and drugs being provided in patients with osteoporosis, such as nonsteroidal anti-inflammatory drugs and corticosteroids....

  9. Hyponatremia, a risk factor for osteoporosis and fractures in women

    DEFF Research Database (Denmark)

    Holm, J P; Amar, A O S; Hyldstrup, L

    2016-01-01

    Hyponatremia has been linked to an increased risk of osteoporosis and fractures. We found an increased hazard ratio of major osteoporotic fractures adjusted for potential confounders, including osteoporosis and medication. A reduced BMD was not sufficiently explaining the association. Our data...... indicate that hyponatremia should be considered a risk factor for osteoporosis and fractures. INTRODUCTION: Hyponatremia is the most common electrolyte disorder in clinical practice and could be a risk factor for both osteoporosis and fractures. Mild hyponatremia has traditionally been regarded as a benign...... and asymptomatic condition; however, data from large population and animal studies have led to a reappraisal of this view. The purpose of this study was to evaluate the association of hyponatremia with osteoporosis and major osteoporotic fractures (MOF) in women. METHODS: This is a historical cohort study...

  10. Guidelines for the diagnosis, prevention and treatment of osteoporosis

    Directory of Open Access Journals (Sweden)

    M. Rossini

    2011-06-01

    Full Text Available The guidelines for the osteoporosis management were first drafted by a working group and then critically evaluated by the board of SIOMMMS. The most relevant points are: Definition: Osteoporosis is defined as a quantitative and qualitative deterioration of bone tissue leading to increased risk of fracture. Postmenopausal and senile osteoporosis are defined as primitive. Diagnosis: The cornerstone for the diagnosis of osteoporosis is the measurement of bone mineral density (BMD by DXA (dual-energy X-ray absortiometry at the femoral neck with T-score values -2.5 is usually not justified. Pharmacological intervention: The use of drugs registered for the treatment of osteoporosis are recommended when the benefits overcome the risk. This is the case only when the risk of fracture is rather high. FRAX™ is recognized as a useful tool for easily estimate the long-term fracture risk. SIOMMMS with these guidelines is committed to validate and further develop this diagnostic tool.

  11. Evaluating the risk of osteoporosis through bone mass density

    International Nuclear Information System (INIS)

    Sayed, S.A.; Khaliq, A.

    2017-01-01

    Osteoporosis is a bone disorder, characterized by loss of bone mass density. Osteoporosis affects more than 30 percent of post-menopausal women. Osteoporosis is often associated with restricted body movement, pain and joint deformities. Early identification and early intervention can help in reducing these complications. The primary objective of this study was to estimate the burden of Osteoporosis in Urban setting of Sindh among women of different age groups and to access the effect of different protective measures that can reduce the risk of Osteoporosis. Method: In this study, 500 women's of 3 major cities of Sindh were approached by non-probability convenience sampling technique. Women bearing age 20 years or more were included. Women who fall under inclusion criteria were screened for BMD (Bone mineral density) test and were classified as Healthy, Osteopenic and Osteoporotic based on their T-score. The association of different protective measures and risk of osteoporosis was assessed by prevalence relative risk (PRR). Result: The result of this study indicate that the burden of Osteoporosis is very high among the women of Sindh, only 17.4 percent (84) women were found to have normal BMD score. The life style of majority of women was sedentary. The PRR calculated for Exposure to sunlight, regular exercise, and use of nutritional supplement was 12.5, 5.19 and 2.72 folds respectively. Conclusion: The results of study reveal that exposure to sunlight, regular physical exercise and use of nutritional supplements found to be effective in reducing the risk of osteoporosis among women of all age group. Health education and promotion toward osteoporosis prevention can significantly contribute in reducing the morbidity of osteoporosis. (author)

  12. Evaluating The Risk Of Osteoporosis Through Bone Mass Density.

    Science.gov (United States)

    Sayed, Sayeeda Amber; Khaliq, Asif; Mahmood, Ashar

    2016-01-01

    Osteoporosis is a bone disorder, characterized by loss of bone mass density. Osteoporosis affects more than 30% of post-menopausal women. Osteoporosis is often associated with restricted body movement, pain and joint deformities. Early identification and early intervention can help in reducing these complications. The primary objective of this study was to estimate the burden of Osteoporosis in Urban setting of Sindh among women of different age groups and to access the effect of different protective measures that can reduce the risk of Osteoporosis. In this study, 500 women's of 3 major cities of Sindh were approached by non-probability convenience sampling technique. Women bearing age 20 years or more were included. Women who fall under inclusion criteria were screened for BMD (Bone mineral density) test and were classified as Healthy, Osteopenic and Osteoporotic based on their T-score. The association of different protective measures and risk of osteoporosis was assessed by prevalence relative risk (PRR). The result of this study indicate that the burden of Osteoporosis is very high among the women of Sindh, only 17.4% (84) women were found to have normal BMD score. The life style of majority of women was sedentary. The PRR calculated for Exposure to sunlight, regular exercise, and use of nutritional supplement was 12.5, 5.19 and 2.72 folds respectively. The results of study reveal that exposure to sunlight, regular physical exercise and use of nutritional supplements found to be effective in reducing the risk of osteoporosis among women of all age group. Health education and promotion toward osteoporosis prevention can significantly contribute in reducing the morbidity of osteoporosis.

  13. A review on the performance of osteoporosis self-assessment tool for Asians in determining osteoporosis and fracture risk.

    Science.gov (United States)

    Chin, Kok-Yong

    2017-09-01

    The prevalence of osteoporosis in Asian countries is growing. An effective screening method will enable patients at risk for osteoporosis to receive early diagnosis and treatment, and avoid overcrowding the limited dual-energy x-ray absorptiometry (DXA) machines available in Asian countries. Many simple osteoporosis screening algorithms have been developed but they are not validated for use in Asian populations. osteoporosis self-assessment tools for Asians (OSTA), established using a multinational Asian cohort, is the first screening algorithm that caters for the Asian populations. It considers only body weight and age in the algorithm. It shows consistently high performance and sensitivity in identifying postmenopausal women at risk for osteoporosis in many Asian countries. Its usage has been expanded for identifying osteoporosis in men, as well as determining fracture risk for both sexes. However, the performance of OSTA is influenced by age, sex, ethnicity and site of BMD measurement to define osteoporosis. Its usage is also limited in individuals without apparent risk factors. These limitations should be noted by physicians considering the use of OSTA in clinical setting. As a conclusion, OSTA is a cost-effective measure for osteoporosis screening in primary healthcare setting.

  14. Electricity market readiness plan : Ontario Energy Board

    International Nuclear Information System (INIS)

    2001-03-01

    This document informs electric power market participants of the Ontario Energy Board's newly developed market readiness plan and target timelines that local distribution companies (LDCs) must meet for retail marketing. The Ontario Energy Board's plan incorporates relevant independent market operator (IMO)-administered market milestones with retail market readiness targeted for September 2001. The market readiness framework involves a self-certification process for LDCs by August 10, 2001, through which the Board will be able to monitor progress and assess the feasibility of meeting the target timelines. For retail market readiness, all LDCs will have to calculate settlement costs, produce unbundled bills, provide standard supply service, change suppliers and accommodate retail transactions. LDCs must be either authorized participants in the IMO-administered market or become retail customers of their host LDC. Unbundled bills will include itemized charges for energy price, transmission, distribution and debt retirement charge. 1 tab., 1 fig

  15. An Outbreak of Foodborne Botulism in Ontario

    Directory of Open Access Journals (Sweden)

    Mona R Loutfy

    2003-01-01

    Full Text Available Botulism is a rare paralytic illness resulting from a potent neurotoxin produced by Clostridium botulinum. Botulism in Canada is predominately due to C botulinum type E and affects mainly the First Nations and Inuit populations. The most recent outbreak of botulism in Ontario was in Ottawa in 1991 and was caused by C botulinum type A. We report an outbreak of foodborne type B botulism in Ontario, which implicated home-canned tomatoes. The outbreak was characterized by mild symptoms in two cases and moderately severe illness in one case. The investigation shows the importance of considering the diagnosis of botulism in patients presenting with cranial nerve and autonomic dysfunction, especially when combined with gastrointestinal complaints; it also highlights the importance of proper home canning technique.

  16. Quantitative Ultrasond in the assessment of Osteoporosis

    International Nuclear Information System (INIS)

    Guglielmi, Giuseppe; Terlizzi, Francesca de

    2009-01-01

    Quantitative ultrasound (QUS) is used in the clinical setting to identify changes in bone tissue connected with menopause, osteoporosis and bone fragility. The versatility of the technique, its low cost and lack of ionizing radiation have led to the use of this method worldwide. Furthermore, with increased clinical interest among clinicians, QUS has been applied to several field of investigation of bone, in various pathologies of bone metabolism, in paediatrics, neonatology, genetics and other fields. Several studies have been carried out in recent years to investigate the potential of QUS, with important positive results. The technique is able to predict osteoporotic fractures; some evidence of the ability to monitor therapies has been reported; the usefulness in the management of secondary osteoporosis has been confirmed; studies in paediatrics have reported reference curves for some QUS devices, and there have been relevant studies in conditions involving metabolic bone disorders. This article is an overview of the most relevant developments in the field of QUS, both in the clinical and in the experimental settings. The advantages and limitations of the present technique have been outlined, together with suggestions for the use in the clinical practice.

  17. Osteoporosis: Modern Paradigms for Last Century's Bones.

    Science.gov (United States)

    Kruger, Marlena C; Wolber, Frances M

    2016-06-17

    The skeleton is a metabolically active organ undergoing continuously remodelling. With ageing and menopause the balance shifts to increased resorption, leading to a reduction in bone mineral density and disruption of bone microarchitecture. Bone mass accretion and bone metabolism are influenced by systemic hormones as well as genetic and lifestyle factors. The classic paradigm has described osteoporosis as being a "brittle bone" disease that occurs in post-menopausal, thin, Caucasian women with low calcium intakes and/or vitamin D insufficiency. However, a study of black women in Africa demonstrated that higher proportions of body fat did not protect bone health. Isoflavone interventions in Asian postmenopausal women have produced inconsistent bone health benefits, due in part to population heterogeneity in enteric bacterial metabolism of daidzein. A comparison of women and men in several Asian countries identified significant differences between countries in the rate of bone health decline, and a high incidence rate of osteoporosis in both sexes. These studies have revealed significant differences in genetic phenotypes, debunking long-held beliefs and leading to new paradigms in study design. Current studies are now being specifically designed to assess genotype differences between Caucasian, Asian, African, and other phenotypes, and exploring alternative methodology to measure bone architecture.

  18. PIXE studies of osteoporosis preventive treatments

    International Nuclear Information System (INIS)

    Ynsa, M.D.; Pinheiro, T.; Ager, F.J.; Alves, L.C.; Millan, J.C.; Gomez-Zubelbia, M.A.; Respaldiza, M.A.

    2002-01-01

    Particle induced X-ray emission (PIXE) and nuclear microprobe (NMP) have been used in an exploratory work to study elemental alterations in tissues of experimental animals submitted to osteoporosis preventive treatments. Osteopathologies have been associated with several factors, such as hormonal disturbances, metabolic aberrations, low dietary Ca and vitamin D intake, excess of iron, among other possible factors. Hormonal treatments seem to be beneficial to the incorporation of Ca in bone but breast and endometrial cancers constitute significant side effects that cannot be ignored. Wistar female rats were used to test the effect of estrogen therapy in osteoporosis progression. The variations of elemental concentrations in uterus and the Ca content of femoral bones of ovariectomised rats under estrogen therapy were investigated. PIXE, Rutherford backscattering spectrometry and secondary electron microscopy techniques were applied for the characterisation of biological materials, with respect to morphology and trace element distribution determination. The increase of Ca and Fe concentrations in uterus and the variations for Ca distribution patterns in bone of rats submitted to estrogen therapy were the major features observed

  19. Osteoporosis presenting in pregnancy, puerperium, and lactation.

    Science.gov (United States)

    Kovacs, Christopher S

    2014-12-01

    To describe our current state of knowledge about the pathophysiology, incidence, and treatment of osteoporosis that presents during pregnancy, puerperium, and lactation. When vertebral fractures occur in pregnant or lactating women, it is usually unknown whether the skeleton was normal before pregnancy. Maternal adaptations increase bone resorption modestly during pregnancy but markedly during lactation. The net bone loss may occasionally precipitate fractures, especially in women who have underlying low bone mass or skeletal fragility prior to pregnancy. Bone mass and strength are normally restored postweaning. Transient osteoporosis of the hip is a sporadic disorder localized to one or both femoral heads; it is not due to generalized skeletal resorption. Anecdotal reports have used bisphosphonates, strontium ranelate, teriparatide, or vertebroplasty/kyphoplasty to treat postpartum vertebral fractures, but it is unclear whether these therapies had any added benefit over the spontaneous skeletal recovery that normally occurs after weaning. These relatively rare fragility fractures result from multifactorial causes, including skeletal disorders that precede pregnancy, and structural and metabolic stresses that can compromise skeletal strength during pregnancy and lactation. Further study is needed to determine when pharmacological or surgical therapy is warranted instead of conservative or expectant management.

  20. Osteoporosis and Sarcopenia in Older Age

    Science.gov (United States)

    Edwards, MH; Dennison, EM; Sayer, A Aihie; Fielding, R; Cooper, C

    2015-01-01

    Osteoporosis and sarcopenia are common in older age and associated with significant morbidity and mortality. Consequently, they are both attended by a considerable socioeconomic burden. Osteoporosis was defined by the World Health Organisation (WHO) in 1994 as a bone mineral density of less than 2.5 standard deviations below the sex-specific young adult mean and this characterisation has been adopted globally. Subsequently, a further step forward was taken when bone mineral density was incorporated into fracture risk prediction algorithms, such as the Fracture Risk Assessment Tool (FRAX®) also developed by the WHO. In contrast, for sarcopenia there have been several diagnostic criteria suggested, initially relating to low muscle mass alone and more recently low muscle mass and muscle function. However, none of these have been universally accepted. This has led to difficulties in accurately delineating the burden of disease, exploring geographic differences, and recruiting appropriate subjects to clinical trials. There is also uncertainty about how improvement in sarcopenia should be measured in pharmaceutical trials. Reasons for these difficulties including the number of facets of muscle health available, e.g. mass, strength, function, and performance, and the various clinical outcomes to which sarcopenia can be related such as falls, fracture, disability and premature mortality. It is imperative that a universal definition of sarcopenia is reached soon to facilitate greater progress in research into this debilitating condition. PMID:25886902

  1. Quantitative Ultrasond in the assessment of Osteoporosis

    Energy Technology Data Exchange (ETDEWEB)

    Guglielmi, Giuseppe [Department of Radiology, University of Foggia, Viale L. Pinto, 71100 Foggia (Italy); Department of Radiology, Scientific Institute Hospital, San Giovanni Rotondo (Italy)], E-mail: g.guglielmi@unifg.it; Terlizzi, Francesca de [IGEA srl, Via Parmenide 10/A 41012 Carpi, MO (Italy)], E-mail: f.deterlizzi@igeamedical.com

    2009-09-15

    Quantitative ultrasound (QUS) is used in the clinical setting to identify changes in bone tissue connected with menopause, osteoporosis and bone fragility. The versatility of the technique, its low cost and lack of ionizing radiation have led to the use of this method worldwide. Furthermore, with increased clinical interest among clinicians, QUS has been applied to several field of investigation of bone, in various pathologies of bone metabolism, in paediatrics, neonatology, genetics and other fields. Several studies have been carried out in recent years to investigate the potential of QUS, with important positive results. The technique is able to predict osteoporotic fractures; some evidence of the ability to monitor therapies has been reported; the usefulness in the management of secondary osteoporosis has been confirmed; studies in paediatrics have reported reference curves for some QUS devices, and there have been relevant studies in conditions involving metabolic bone disorders. This article is an overview of the most relevant developments in the field of QUS, both in the clinical and in the experimental settings. The advantages and limitations of the present technique have been outlined, together with suggestions for the use in the clinical practice.

  2. Calcium supplementation in osteoporosis: useful or harmful?

    Science.gov (United States)

    Chiodini, Iacopo; Bolland, Mark J

    2018-04-01

    Osteoporosis and fragility fractures are important social and economic problems worldwide and are due to both the loss of bone mineral density and sarcopenia. Indeed, fragility fractures are associated with increased disability, morbidity and mortality. It is known that a normal calcium balance together with a normal vitamin D status is important for maintaining well-balanced bone metabolism, and for many years, calcium and vitamin D have been considered crucial in the prevention and treatment of osteoporosis. However, recently, the usefulness of calcium supplementation (alone or with concomitant vitamin D) has been questioned, since some studies reported only weak efficacy of these supplementations in reducing fragility fracture risk. On the other hand, besides the gastrointestinal side effects of calcium supplements and the risk of kidney stones related to use of co-administered calcium and vitamin D supplements, other recent data suggested potential adverse cardiovascular effects from calcium supplementation. This debate article is focused on the evidence regarding both the possible usefulness for bone health and the potential harmful effects of calcium and/or calcium with vitamin D supplementation. © 2018 European Society of Endocrinology.

  3. The Role of Calcium in Osteoporosis

    Science.gov (United States)

    Arnaud, C. D.; Sanchez, S. D.

    1991-01-01

    Calcium requirements may vary throughout the lifespan. During the growth years and up to age 25 to 30, it is important to maximize dietary intake of calcium to maintain positive calcium balance and achieve peak bone mass, thereby possibly decreasing the risk of fracture when bone is subsequently lost. Calcium intake need not be greater than 800 mg/day during the relatively short period of time between the end of bone building and the onset of bone loss (30 to 40 years). Starting at age 40 to 50, both men and women lose bone slowly, but women lose bone more rapidly around the menopause and for about 10 years after. Intestinal calcium absorption and the ability to adapt to low calcium diets are impaired in many postmenopausal women and elderly persons owing to a suspected functional or absolute decrease in the ability of the kidney to produce 1,25(OH)2D2. The bones then become more and more a source of calcium to maintain critical extracellular fluid calcium levels. Excessive dietary intake of protein and fiber may induce significant negative calcium balance and thus increase dietary calcium requirements. Generally, the strongest risk factors for osteoporosis are uncontrollable (e.g., sex, age, and race) or less controllable (e.g., disease and medications). However, several factors such as diet, physical activity, cigarette smoking, and alcohol use are lifestyle related and can be modified to help reduce the risk of osteoporosis.

  4. Knowledge and behaviour regarding osteoporosis in women

    International Nuclear Information System (INIS)

    Kamran, M.; Iftikhar, A.; Awan, A.A.

    2016-01-01

    To evaluate the knowledge, attitude and practice regarding osteoporosis in women belonging to different educational status Study Design: A cross-sectional descriptive study. Place and Duration of Study: Dist. Hattian Bala of Azad Jammu and Kashmir (AJK) from Oct 2015 to Dec 2015. Material and Methods: A total of 410 women between 12-45 years of age were included in the study and grouped according to educational qualification. Women who were health-care workers, already diagnosed with the disease or those who had never heard of the disease were not included in the study. A self-made, pre-validated questionnaire including demographic data and 24 items assessing knowledge, attitude, and practice (KAP) regarding osteoporosis was administered after obtaining verbal informed consent. The scores ranged from 0-15 in knowledge section, 0-4 in attitude section and 0-8 in practice section. The results in each section of KAP were cross tabulated with educational status of the respondents. Results: Books and teachers (34.60 percent) were the main source of information followed by television/ radio (22.40 percent). The mean score for knowledge section was 5.12 +- 1.11, for attitude section 1.65 +- 0.64, and for practice 3.79 +- 2.61. All the three dimensions had significantly better results in women with higher educational status (graduate or more). Conclusion: Women with higher education demonstrated better knowledge, positive attitude and healthier practice than those with lower education. (author)

  5. Could martial arts fall training be safe for persons with osteoporosis?: a feasibility study

    Science.gov (United States)

    2010-01-01

    Background Osteoporosis is a well-established risk factor for fall-related hip fractures. Training fall arrest strategies, such as martial arts (MA) fall techniques, might be useful to prevent hip fractures in persons with osteoporosis, provided that the training itself is safe. This study was conducted to determine whether MA fall training would be safe for persons with osteoporosis extrapolated from the data of young adults and using stringent safety criteria. Methods Young adults performed sideways and forward MA falls from a kneeling position on both a judo mat and a mattress as well as from a standing position on a mattress. Hip impact forces and kinematic data were collected. For each condition, the highest hip impact force was compared with two safety criteria based on the femoral fracture load and the use of a hip protector. Results The highest hip impact force during the various fall conditions ranged between 1426 N and 3132 N. Sideways falls from a kneeling and standing position met the safety criteria if performed on the mattress (max 1426 N and 2012 N, respectively) but not if the falls from a kneeling position were performed on the judo mat (max 2219 N). Forward falls only met the safety criteria if performed from a kneeling position on the mattress (max 2006 N). Hence, forward falls from kneeling position on a judo mat (max 2474 N) and forward falls from standing position on the mattress (max 3132 N) did not meet both safety criteria. Conclusions Based on the data of young adults and safety criteria, the MA fall training was expected to be safe for persons with osteoporosis if appropriate safety measures are taken: during the training persons with osteoporosis should wear hip protectors that could attenuate the maximum hip impact force by at least 65%, perform the fall exercises on a thick mattress, and avoid forward fall exercises from a standing position. Hence, a modified MA fall training might be useful to reduce hip fracture risk in persons with

  6. Could martial arts fall training be safe for persons with osteoporosis?: a feasibility study

    Directory of Open Access Journals (Sweden)

    Smulders Ellen

    2010-04-01

    Full Text Available Abstract Background Osteoporosis is a well-established risk factor for fall-related hip fractures. Training fall arrest strategies, such as martial arts (MA fall techniques, might be useful to prevent hip fractures in persons with osteoporosis, provided that the training itself is safe. This study was conducted to determine whether MA fall training would be safe for persons with osteoporosis extrapolated from the data of young adults and using stringent safety criteria. Methods Young adults performed sideways and forward MA falls from a kneeling position on both a judo mat and a mattress as well as from a standing position on a mattress. Hip impact forces and kinematic data were collected. For each condition, the highest hip impact force was compared with two safety criteria based on the femoral fracture load and the use of a hip protector. Results The highest hip impact force during the various fall conditions ranged between 1426 N and 3132 N. Sideways falls from a kneeling and standing position met the safety criteria if performed on the mattress (max 1426 N and 2012 N, respectively but not if the falls from a kneeling position were performed on the judo mat (max 2219 N. Forward falls only met the safety criteria if performed from a kneeling position on the mattress (max 2006 N. Hence, forward falls from kneeling position on a judo mat (max 2474 N and forward falls from standing position on the mattress (max 3132 N did not meet both safety criteria. Conclusions Based on the data of young adults and safety criteria, the MA fall training was expected to be safe for persons with osteoporosis if appropriate safety measures are taken: during the training persons with osteoporosis should wear hip protectors that could attenuate the maximum hip impact force by at least 65%, perform the fall exercises on a thick mattress, and avoid forward fall exercises from a standing position. Hence, a modified MA fall training might be useful to reduce hip

  7. Interim report on nuclear power in Ontario

    International Nuclear Information System (INIS)

    1978-01-01

    An exhaustive report is presented on the implications of nuclear electric generation for Ontario's energy future. Such aspects as electrical demand and power planning, the CANDU fuel cycle, the nuclear debate, health, environmental and safety concerns, economics, social impacts and the status of the nuclear industry, uranium resources, ethical and political issues, nuclear weapons proliferation and plant security, and the regulation of nuclear power are dealt with in detail. (E.C.B.)

  8. Factors Impacting Student Service Utilization at Ontario Colleges: Key Performance Indicators as a Measure of Success: A Niagara College View

    Science.gov (United States)

    Veres, David

    2015-01-01

    Student success in Ontario College is significantly influenced by the utilization of student services. At Niagara College there has been a significant investment in student services as a strategy to support student success. Utilizing existing KPI data, this quantitative research project is aimed at measuring factors that influence both the use of…

  9. Prevention and treatment of postmenopausal osteoporosis.

    Science.gov (United States)

    Tella, Sri Harsha; Gallagher, J Christopher

    2014-07-01

    In the beginning, that is from the 1960's, when a link between menopause and osteoporosis was first identified; estrogen treatment was the standard for preventing bone loss, however there was no fracture data, even though it was thought to be effective. This continued until the Women's Health Initiative (WHI) study in 2001 that published data on 6 years of treatment with hormone therapy that showed an increase in heart attacks and breast cancer. Even though the risks were small, 1 per 1500 users annually, patients were worried and there was a large drop off in estrogen use. In later analyses the WHI study showed that estrogen reduced fractures and actually prevented heart attacks in the 50-60 year age group. Estrogen alone appeared to be safer to use than estrogen+the progestin medroxyprogesterone acetate and actually reduced breast cancer. At the same time other drugs were being developed for bone that belong to the bisphosphonate group and the first generation of compounds showed moderate potency on bone resorption. The second and third generation compounds were much more potent and in a series of large trials were shown to reduce fractures. For the last 15 years the treatment of osteoporosis belonged to the bisphosphonate compounds, most of which reduce fracture rates by 50 percent. With the exception of gastrointestinal irritation the drugs are well tolerated and highly effective. The sophistication of the delivery systems now allow treatment that can be given daily, weekly, monthly and annually either orally or intravenously. Bone remodeling is a dynamic process that repairs microfractures and replaces old bone with new bone. In the last 10 years there has been a remarkable understanding of bone biology so that new therapies can be specifically designed on a biological basis. The realization that RANKL was the final cytokine involved in the resorption process and that marrow cells produced a natural antagonist called Osteoprotegerin (OPG) quickly led to two

  10. Interconnection issues in Ontario : a status check

    International Nuclear Information System (INIS)

    Helbronner, V.

    2010-01-01

    This PowerPoint presentation discussed wind and renewable energy interconnection issues in Ontario. The province's Green Energy Act established a feed-in tariff (FIT) program and provided priority connection access to the electricity system for renewable energy generation facilities that meet regulatory requirements. As a result of the province's initiatives, Hydro One has identified 20 priority transmission expansion projects and is focusing on servicing renewable resource clusters. As of October 2010, the Ontario Power Authority (OPA) has received 1469 MW of FIT contracts executed for wind projects. A further 5953 MW of wind projects are awaiting approval. A Korean consortium is now planning to develop 2500 MW of renewable energy projects in the province. The OPA has also been asked to develop an updated transmission expansion plan. Transmission/distribution availability tests (TAT/DAT) have been established to determine if there is sufficient connection availability for FIT application projects. Economic connection tests (ECTs) are conducted to assess whether grid upgrade costs to enable additional FIT capacity are justifiable. When projects pass the ECT, grid upgrades needed for the connection included in grid expansion plans. Ontario's long term energy plan was also reviewed. tabs., figs.

  11. A fluvial mercury budget for Lake Ontario.

    Science.gov (United States)

    Denkenberger, Joseph S; Driscoll, Charles T; Mason, Edward; Branfireun, Brian; Warnock, Ashley

    2014-06-03

    Watershed mercury (Hg) flux was calculated for ten inflowing rivers and the outlet for Lake Ontario using empirical measurements from two independent field-sampling programs. Total Hg (THg) flux for nine study watersheds that directly drain into the lake ranged from 0.2 kg/yr to 13 kg/yr, with the dominant fluvial THg load from the Niagara River at 154 kg/yr. THg loss at the outlet (St. Lawrence River) was 68 kg/yr and has declined approximately 40% over the past decade. Fluvial Hg inputs largely (62%) occur in the dissolved fraction and are similar to estimates of atmospheric Hg inputs. Fluvial mass balances suggest strong in-lake retention of particulate Hg inputs (99%), compared to dissolved total Hg (45%) and methyl Hg (22%) fractions. Wetland land cover is a good predictor of methyl Hg yield for Lake Ontario watersheds. Sediment deposition studies, coupled atmospheric and fluvial Hg fluxes, and a comparison of this work with previous measurements indicate that Lake Ontario is a net sink of Hg inputs and not at steady state likely because of recent decreases in point source inputs and atmospheric Hg deposition.

  12. Ontario's energy crisis brings out conflicting visions

    International Nuclear Information System (INIS)

    Kishewitsch, S.

    2004-01-01

    Ontario's medium-term energy supply situation is discussed in light of the Ontario provincial government's insistence on phasing out coal-fired generation by 2007, and the somewhat longer term uncertainty about the aging nuclear fleet and the price tag associated with their overhauling or replacement. Centre to the discussion is the replacement of coal-fired plants by natural gas-fired generating plants, complicated by the fact is that there is already a surfeit of gas-fired plants sitting idle for lack of fuel available at an economically acceptable price. Recent statistics show that conventional gas supplies have already levelled off and unconventional sources, such as coalbed methane, and imports like LNG, are more abundant, but also significantly more expensive. The nuclear option is considered by knowledgeable insiders as a viable option for increased generation, although it is generally acknowledged as a serious public relations problem. The contributions of green power and cogeneration are also explored; the most optimistic estimates put the supply from this source at 50,000 GWh a year; less than the amount needed even in the absence of growth in demand. The overall conclusion is that Ontario's energy future can only be assured by aggressive pursuit of productivity improvements, financial and policy innovations, extensive use of cogeneration, strong development of renewables, energy conservation, efficiency, and demand management

  13. Ontario hydro waste storage concepts and facilities

    International Nuclear Information System (INIS)

    Carter, T.J.; Mentes, G.A.

    1976-01-01

    Ontario Hydro presently operates 2,200 MWe of CANDU heavy water reactors with a further 11,000 MWe under design or construction. The annual quantities of low and medium level solid wastes expected to be produced at these stations are tabulated. In order to manage these wastes, Ontario Hydro established a Radioactive Waste Operations Site within the Bruce Nuclear Power Development located on Lake Huron about 250 km northwest of Toronto. The Waste Operations Site includes a 19-acre Storage Site plus a Radioactive Waste Volume Reduction Facility consisting of an incinerator and waste compactor. Ontario has in use or under construction both in-ground and above-ground storage facilities. In-ground facilities have been used for a number of years while the above-ground facilities are a more recent approach. Water, either in the form of precipitation, surface or subsurface water, presents the greatest concern with respect to confinement integrity and safe waste handling and storage operations

  14. Reappraisal of the seismotectonics of southern Ontario

    International Nuclear Information System (INIS)

    Mohajer, A.A.

    1987-11-01

    The fundamental objectives of this study were to review and improve the seismological data base as an aid in more realistic evaluation of seismic hazard in southern Ontario. For this purpose, the following procedures have been undertaken: In the first stage, the types of errors in earthquake location files are identified, sources of uncertainties are discussed and a sensitivity analysis of the errors to different parameters is presented. In the second stage, a group location technique, Joint Hypocenter Determination (JHD), has been utilized to improve the locations of a group of 67 well-recorded events, mostly from the more active region near the Ottawa River and in western Quebec. The third stage, to relocate smaller and less reliably detected events in southern Ontario, utilized a nw algorithm, 'HYPOCENTER', which proved very efficient and flexible in the test runs for handling local explosion and natural events. A preliminary interpretation of the seismicity patterns in the study regions shows that earthquakes of magnitude 3 and larger tend to align along preferred seismic trends which may, in turn, be controlled by weakness planes in the Earth's crust. These inferred trends coincide with dominant northwesterly and northeasterly striking structural directions. For earthquakes smaller than magnitude 4 prior to 1970 and for microearthquakes (M<3) which occurred near the Lake Ontario shoreline, the detection coverage was not sufficient to conclusively discuss accurate locations and causative mechanisms

  15. Climate change impacts: an Ontario perspective

    International Nuclear Information System (INIS)

    Mortsch, L.

    1995-11-01

    Significant changes in the climate system which are likely to affect biophysical, social and economic systems in various ways, were discussed. Trends in greenhouse gas levels show that during the 20. century, human activity has changed the make-up of the atmosphere and its greenhouse effect properties. A pilot study on the impacts of climate change identified changes in the water regime such as declines in net basin supply, lake levels and outflows, as important concerns. These changes would have impacts on water quality, wetlands, municipal water supply, hydroelectric power generation, commercial shipping, tourism and recreation, and to a lesser extent, on food productions. Climate impact assessments suggest that world conditions will change significantly as a result. Those with less resources are likely to be most affected by climate change, and the impacts on other regions of the world will be more significant to Ontario than the direct impacts on Ontario itself. In an effort to keep pace with global changes, Ontario will have to limit emissions, conduct research in innovative technology and develop greater awareness of the risk of climate change. refs., tabs., figs

  16. Parental perceptions of school-based influenza immunisation in Ontario, Canada: a qualitative study

    Science.gov (United States)

    MacDougall, Donna; Crowe, Lois; Pereira, Jennifer A; Kwong, Jeffrey C; Quach, Susan; Wormsbecker, Anne E; Ramsay, Hilary; Salvadori, Marina I; Russell, Margaret L

    2014-01-01

    Objective To understand the perspectives of Ontario parents regarding the advantages and disadvantages of adding influenza immunisation to the currently existing Ontario school-based immunisation programmes. Design Descriptive qualitative study. Participants Parents of school-age children in Ontario, Canada, who were recruited using a variety of electronic strategies (social media, emails and media releases), and identified as eligible (Ontario resident, parent of one or more school-age children, able to read/write English) on the basis of a screening questionnaire. We used stratified purposeful sampling to obtain maximum variation in two groups: parents who had ever immunised at least one child against influenza or who had never done so. We conducted focus groups (teleconference or internet forum) and individual interviews to collect data. Thematic analysis was used to analyse the data. Setting Ontario, Canada. Results Of the 55 participants, 16 took part in four teleconference focus groups, 35 in 6 internet forum focus groups and four in individual interviews conducted between October 2012 and February 2013. Participants who stated that a school-based influenza immunisation programme would be worthwhile for their child valued its convenience and its potential to reduce influenza transmission without interfering with the family routine. However, most thought that for a programme to be acceptable, it would need to be well designed and voluntary, with adequate parental control and transparent communication between the key stakeholder groups of public health, schools and parents. Conclusions These results will benefit decision-makers in the public health and education sectors as they consider the advantages and disadvantages of immunising children in schools as part of a system-wide influenza prevention approach. Further research is needed to assess the perceptions of school board and public health stakeholders. PMID:24902736

  17. Modeling livestock population structure: a geospatial database for Ontario swine farms.

    Science.gov (United States)

    Khan, Salah Uddin; O'Sullivan, Terri L; Poljak, Zvonimir; Alsop, Janet; Greer, Amy L

    2018-01-30

    Infectious diseases in farmed animals have economic, social, and health consequences. Foreign animal diseases (FAD) of swine are of significant concern. Mathematical and simulation models are often used to simulate FAD outbreaks and best practices for control. However, simulation outcomes are sensitive to the population structure used. Within Canada, access to individual swine farm population data with which to parameterize models is a challenge because of privacy concerns. Our objective was to develop a methodology to model the farmed swine population in Ontario, Canada that could represent the existing population structure and improve the efficacy of simulation models. We developed a swine population model based on the factors such as facilities supporting farm infrastructure, land availability, zoning and local regulations, and natural geographic barriers that could affect swine farming in Ontario. Assigned farm locations were equal to the swine farm density described in the 2011 Canadian Census of Agriculture. Farms were then randomly assigned to farm types proportional to the existing swine herd types. We compared the swine population models with a known database of swine farm locations in Ontario and found that the modeled population was representative of farm locations with a high accuracy (AUC: 0.91, Standard deviation: 0.02) suggesting that our algorithm generated a reasonable approximation of farm locations in Ontario. In the absence of a readily accessible dataset providing details of the relative locations of swine farms in Ontario, development of a model livestock population that captures key characteristics of the true population structure while protecting privacy concerns is an important methodological advancement. This methodology will be useful for individuals interested in modeling the spread of pathogens between farms across a landscape and using these models to evaluate disease control strategies.

  18. Mental Health Consultation Among Ontario's Immigrant Populations.

    Science.gov (United States)

    Islam, Farah; Khanlou, Nazilla; Macpherson, Alison; Tamim, Hala

    2017-11-16

    To determine the prevalence rates and characteristics of past-year mental health consultation for Ontario's adult (18 + years old) immigrant populations. The Canadian Community Health Survey (CCHS) 2012 was used to calculate the prevalence rates of past-year mental health consultation by service provider type. Characteristics associated with mental health consultation were determined by carrying out multivariable logistic regression analysis on merged CCHS 2008-2012 data. Adult immigrant populations in Ontario (n = 3995) had lower estimated prevalence rates of past-year mental health consultation across all service provider types compared to Canadian-born populations (n = 14,644). Amongst those who reported past-year mental health consultation, 57.89% of Ontario immigrants contacted their primary care physician, which was significantly higher than the proportion who consulted their family doctor from Canadian-born populations (45.31%). The factors of gender, age, racial/ethnic background, education level, working status, food insecurity status, self-perceived health status, smoking status, alcohol drinking status, years since immigration, and age at time of immigration were significantly associated with past-year mental health consultation for immigrant populations. Ontario's adult immigrant populations most commonly consult their family doctor for mental health care. Potential exists for expanding the mental health care role of primary care physicians as well as efforts to increase accessibility of specialized mental health services. Integrated, coordinated care where primary care physicians, specialized mental health professionals, social workers, and community educators, etc. working together in a sort of "one-stop-shop" may be the most effective way to mitigate gaps in the mental health care system. In order to effectively tailor mental health policy, programming, and promotion to suit the needs of immigrant populations initiatives that focus on

  19. Lake Ontario benthic prey fish assessment, 2015

    Science.gov (United States)

    Weidel, Brian C.; Walsh, Maureen; Holden, Jeremy P.; Connerton, Michael J.

    2016-01-01

    Benthic prey fishes are a critical component of the Lake Ontario food web, serving as energy vectors from benthic invertebrates to native and introduced piscivores. Since the late 1970’s, Lake Ontario benthic prey fish status was primarily assessed using bottom trawl observations confined to the lake’s south shore, in waters from 8 – 150 m (26 – 492 ft). In 2015, the Benthic Prey Fish Survey was cooperatively adjusted and expanded to address resource management information needs including lake-wide benthic prey fish population dynamics. Effort increased from 55 bottom trawl sites to 135 trawl sites collected in depths from 8 - 225m (26 – 738 ft). The spatial coverage of sampling was also expanded and occurred in all major lake basins. The resulting distribution of tow depths more closely matched the available lake depth distribution. The additional effort illustrated how previous surveys were underestimating lake-wide Deepwater Sculpin, Myoxocephalus thompsonii, abundance by not sampling in areas of highest density. We also found species richness was greater in the new sampling sites relative to the historic sites with 11 new fish species caught in the new sites including juvenile Round Whitefish, Prosopium cylindraceum, and Mottled sculpin, Cottus bairdii. Species-specific assessments found Slimy Sculpin, Cottus cognatus abundance increased slightly in 2015 relative to 2014, while Deepwater Sculpin and Round Goby, Neogobius melanostomus, dramatically increased in 2015, relative to 2014. The cooperative, lake-wide Benthic Prey Fish Survey expanded our understanding of benthic fish population dynamics and habitat use in Lake Ontario. This survey’s data and interpretations influence international resource management decision making, such as informing the Deepwater Sculpin conservation status and assessing the balance between sport fish consumption and prey fish populations. Additionally a significant Lake Ontario event occurred in May 2015 when a single

  20. Proceedings of the Ontario Energy Association's 2004 annual conference

    International Nuclear Information System (INIS)

    2004-01-01

    The Ontario Energy Association (OEA) is a unique trade association that represents key participants in Ontario's converging natural gas and electricity industries. Its members include energy producers, transmitters, distributors, marketers, and retailers. This conference provided a forum to discuss the role of energy policy and energy conservation in promoting competitive and efficient gas and electricity markets in Ontario. The conference featured 15 presentations, of which 3 have been catalogued separately for inclusion in this database

  1. Impacto de la osteoporosis en el desarrollo social Impact of osteoporosis in the social development

    Directory of Open Access Journals (Sweden)

    Ana Rosa Jorna Calixto

    2010-12-01

    Full Text Available INTRODUCCIÓN: la osteoporosis constituye un problema social, económico y de salud pública con características de epidemia en los países desarrollados, que nos obliga a preparar y difundir programas de promoción de salud y prevención de enfermedades, porque se conocen los factores de riesgo y se dispone de métodos diagnósticos para cuantificar la masa ósea y su pérdida. El estudio de los factores que influyen en la salud es un aspecto importante dentro de un planteamiento sociopolítico que aspire al logro de la estabilidad de las sociedades. OBJETIVOS: analizar la incidencia de los aspectos socioeconómicos en el desarrollo de la osteoporosis, así como valorar la responsabilidad social de la comunidad científica en el planteamiento de posibles soluciones. DESARROLLO: los costos del tratamiento de la osteoporosis son cuantiosos y la tendencia es que se incrementen aún más, no obstante, a pesar de que Cuba atraviesa serias dificultades en el orden económico ocasionadas, sobre todo, por el bloqueo económico impuesto por el gobierno de EE. UU., el estado cubano ha mantenido una atención priorizada al sector salud, que incluye el desarrollo de un sistema de atención que cubre a toda la población y que ha hecho posible alcanzar y sostener importantes logros en esta esfera. CONCLUSIONES: las restricciones impuestas a la adquisición de suministros y tecnologías médicas de procedencia norteamericana para su empleo en Cuba, han causado considerables perjuicios a los servicios de la salud pública. La osteoporosis requiere de acciones con otras entidades fuera del sistema de salud para prevenirla, y de una acción directa sobre los factores de riesgo que la provocan. Los profesionales de la atención primaria se enfrentan a problemas éticos y legales por la alta demanda de los servicios de salud y sociales de estos pacientes.INTRODUCTION: the osteoporosis is a social, economic and of public health problem characterized by epidemics

  2. Osteoporosis: knowledge and practices among females of reproductive age group

    International Nuclear Information System (INIS)

    Idrees, Z.; Zakir, U.; Khushdil, A.; Shehzadi, H.

    2017-01-01

    To assess the knowledge of osteoporosis and evaluation of the practice of osteoporosis preventive measures, among females of reproductive age group. Methodology: A cross-sectional questionnaire based study was undertaken from September 2015 to February 2016 on 174 females (age range 15-49 years) from Military Hospital and Combined Military Hospital, Rawalpindi, Pakistan through non- probability convenient sampling. Females with any metabolic, muscular or diagnosed bone disease were excluded from the study. The self -administered questionnaire consisted of questions regarding basic demographics, knowledge and practice of preventive factors related to osteoporosis. Result: Majority (86.8%) females knew about osteoporosis. 80% considered major risk factor to be low calcium intake. Regarding practices, 44.3% of women practiced daily intake of milk in their diet, 69.5 % females practiced physical activity like walking on daily basis and 65.5% have direct exposure of sunlight but only 12.1% of women used calcium supplements. Conclusion: The study revealed that majority of the women knew about osteoporosis and its risk factors but many of them were not practicing appropriate lifestyle and dietary habits to decrease their risk of osteoporosis. Thus, there is a need of standardized approach to promote healthy behaviors to decrease the risk of osteoporosis before menopause. (author)

  3. Epidemiology and treatment of osteoporosis in women: an Indian perspective.

    Science.gov (United States)

    Khadilkar, Anuradha V; Mandlik, Rubina M

    2015-01-01

    The number of women with osteoporosis, ie, with reduced bone mass and the disruption of bone architecture, is increasing in India. While data on prevalence of osteoporosis among women in India come from studies conducted in small groups spread across the country, estimates suggest that of the 230 million Indians expected to be over the age of 50 years in 2015, 20%, ie, ~46 million, are women with osteoporosis. Thus, osteoporosis is a major public health problem in Indian women. Low calcium intakes with extensive prevalence of vitamin D deficiency, increasing longevity, sex inequality, early menopause, genetic predisposition, lack of diagnostic facilities, and poor knowledge of bone health have contributed toward the high prevalence of osteoporosis. Bone health may be optimized by creating an environment to achieve peak bone mass during adolescence, maintenance of healthy bone throughout the life cycle, and prevention of bone loss postmenopausal. In Indian women, calcium, vitamin D, and bisphosphonates are the commonest first-line therapies used. The use of other drugs such as hormone replacement therapy, estrogen agonists, calcitonin, parathyroid hormone, and denosumab is decided as per the affordability and availability of treatment options. Major gaps still remain in the diagnosis and management of osteoporosis, thus highlighting the need for more structured research in this area. This review focuses on the epidemiology of osteoporosis in Indian women and available treatments.

  4. Awareness and knowledge of osteoporosis in Vietnamese women.

    Science.gov (United States)

    Nguyen, Nguyen V; Dinh, Tri A; Ngo, Quang V; Tran, Vinh D; Breitkopf, Carmen Radecki

    2015-03-01

    Vietnamese women are at particular risk of osteoporosis and its complications. This study examined osteoporosis knowledge and awareness among Vietnamese women who have accessed health care. A sample of 217 women, 13 to 76 years of age, who were attending 1 of 2 health care facilities in Da Nang, Vietnam, between November and December 2009 completed a questionnaire assessing their awareness of osteoporosis and measuring their knowledge using a 30-item instrument reflecting 9 knowledge domains (eg, risk factors, diagnosis, prognosis). A majority (81.6%) of the women had heard of osteoporosis. Awareness was associated with education, working in health care, and having a family member with osteoporosis. On average, Vietnamese women answered 49% of the knowledge questions correctly; scores ranged from 0 to 26 questions correct out of 30 (mean = 14.71 ± 5.2, median = 15). Mean knowledge scores were higher among those reporting a family member with osteoporosis, nurses (vs other vocations), and women with a high school education or greater (relative to those who had not completed high school). More than 90% of the women expressed interest in a prevention and treatment program. Vietnamese women may have heard of osteoporosis, yet they would benefit from education targeting prevention and treatment of the disease. © 2011 APJPH.

  5. Association between tea consumption and osteoporosis: A meta-analysis.

    Science.gov (United States)

    Sun, Kang; Wang, Le; Ma, Qingping; Cui, Qiaoyun; Lv, Qianru; Zhang, Wenzheng; Li, Xinghui

    2017-12-01

    Previous reports have suggested a potential association of tea consumption with the risk of osteoporosis. As such association is controversial, we conducted a meta-analysis to assess the relationship between tea consumption and osteoporosis. We systematically searched PubMed, EMBASE and WanFang databases until March 30, 2016, using the keywords "tea and osteoporosis," without limits of language. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were derived by using random-effects models throughout the analyses. We conducted the analysis of the statistical heterogeneity using Cochrane I. The funnel plot was used to speculate the publication bias, while the subgroup analysis and multiround elimination method were employed. Our study was based on 17 journal articles, including 2 prospective cohort studies, 4 case-control studies, and 11 cross-sectional studies. In the present study, the total OR of osteoporosis for the highest versus the lowest categories of tea consumption was 0.62 (95% CI, 0.46-0.83), with significant heterogeneity among studies (I = 94%, P tea consumption and osteoporosis. Subgroup analysis showed that tea consumption could reduce the risk of osteoporosis in all examined subgroups. In the present study, it can be concluded from the results that tea consumption can reduce the risk of osteoporosis.

  6. Leveraging Scarce Resources With Bone Health TeleECHO to Improve the Care of Osteoporosis.

    Science.gov (United States)

    Lewiecki, E Michael; Rochelle, Rachelle; Bouchonville, Matthew F; Chafey, David H; Olenginski, Thomas P; Arora, Sanjeev

    2017-12-01

    Osteoporosis is a common condition with serious consequences because of fractures. Despite availability of treatments to reduce fracture risk, there is a large osteoporosis treatment gap that has reached crisis proportions. There are too few specialists to provide services for patients who need them. Bone Health Extension for Community Health Care Outcomes (TeleECHO) is a strategy using real-time ongoing videoconferencing technology to mentor health care professionals in rural and underserved communities to achieve an advanced level of knowledge for the care of patients with skeletal diseases. Over the first 21 months of weekly Bone Health TeleECHO programs, there were 263 registered health care professionals in the United States and several other countries, with 221 attending at least 1 online clinic and typically 35 to 40 attendees at each session at the end of the reported period. Assessment of self-confidence in 20 domains of osteoporosis care showed substantial improvement with the ECHO intervention ( P = 0.005). Bone Health TeleECHO can contribute to mitigating the crisis in osteoporosis care by leveraging scarce resources, providing motivated practitioners with skills to provide better skeletal health care, closer to home, with greater convenience, and lower cost than referral to a specialty center. Bone Health TeleECHO can be replicated in any location worldwide to reach anyone with Internet access, allowing access in local time zones and languages. The ECHO model of learning can be applied to other aspects of bone care, including the education of fracture liaison service coordinators, residents and fellows, and physicians with an interest in rare bone diseases.

  7. An examination of recovery planning for forest-dwelling woodland caribou (Rangifer tarandus caribou in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Christopher J. A. Wilkinson

    2008-04-01

    Full Text Available Ontario’s population of forest-dwelling woodland caribou is listed both federally and provincially as a species at risk. It is estimated that 20 000 woodland caribou remain in Ontario, of which approximately one quarter inhabit the boreal forest and are described as the sedentary forest-dwelling population. This paper examines the recovery strategy for this population developed by the Ministry of Natural Resources, as well as discussing the implications of provincial forestry policy on woodland caribou management. Commercial timber harvesting will likely soon be allowed in parts of the northern third of the province, in which woodland caribou habitat currently is relatively unimpaired by industrial development. Abstract in Norwegian / Sammendrag:Planlegging for bevaring av skogsøkotypen av Rangifer tarandus caribou i Ontario, CanadaSkogsvillreinen av skogsøkotypen i Ontario er vurdert som sårbar både føderalt og på provinsnivå. Av provinsens rundt 20 000 skogsvillrein hører omtrent en fjerdepart til den stasjonære skogsboende skogsøkoypen. Artikkelen ser på bevaringsstrategien som er utarbeidet av naturressursdepartementet i Ontario for denne spesielle bestanden og diskuterer konsekvensene for villreinen av provinsens skogpolitikk. Kommersiell hogst vil mest sannsynlig og snart bli tillatt i deler av Ontarios nordlige tredel der skogvillreinens leveområder er relativt upåvirket av industriell virksomhet.

  8. Transient osteoporosis: Not just the hip to worry about

    Directory of Open Access Journals (Sweden)

    Nicola Berman, MD

    2016-12-01

    Full Text Available Transient osteoporosis (TO is a clinical syndrome characterized by joint pain and the presence of bone marrow edema on magnetic resonance imaging (MRI, both of which spontaneously resolve over time. Transient osteoporosis most commonly affects the hip, but also may involve other lower extremity sites. TO likely represents a disorder that may be monoarticular or “migratory” with involvement of two or more lower extremity sites sequentially affected over a number of months. We report on two cases of transient osteoporosis, one involving the knee and one involving the hip, demonstrating the utility of serial bone mineral density measurements at both sites. Additionally, we are able to report on the microarchitectural changes seen at the distal femur on ultra-high resolution (7 T MRI. Case #1 describes a recurrence of transient osteoporosis of the hip three years after a similar presentation at the contralateral hip and highlights the findings of rapidly changing bone mineral density in this clinical syndrome. In contrast to the spine, hip and forearm, peripheral bone density measurements at the knee are rarely reported and to our knowledge Case #2 represents the first report of transient osteoporosis of the knee demonstrating bone density findings similar to that seen in the hip. We postulate that transient osteoporosis of the knee is part of a clinical spectrum most commonly seen in the hip and one that is marked by lower extremity joint pain, bone marrow edema on MRI and transient decreases in bone mineral density all of which spontaneously resolve without sequelae. Keywords: Transient osteoporosis, Transient osteoporosis of the hip, Transient osteoporosis of the knee, Bone marrow edema, High resolution 7 T MRI

  9. Assessment of postmenopausal women and significant risk factors for osteoporosis.

    Science.gov (United States)

    Schnatz, Peter F; Marakovits, Kimberly A; O'Sullivan, David M

    2010-09-01

    The assessment of osteoporosis risk factors can help guide early intervention. The objective of this study was to analyze numerous potential risk factors to see which were associated with postmenopausal osteoporosis. Women aged 49 or greater presenting for dual-energy x-ray absorptiometry bone scans were recruited from radiology sites in the Hartford, Connecticut, area between January 2007 and March 2009, inclusive. Information was collected regarding primary and secondary risk factors for osteoporosis development, as well as family history and history of pregnancy and breast-feeding. Survey results were subsequently correlated with each woman's dual-energy x-ray absorptiometry scan results. In a sample of 619 women, history of fracture (odds ratio [OR], 12.49), weight less than 127 pounds (OR, 3.50), and use of anticoagulants (OR, 5.40) increased the chance of developing osteoporosis. In contrast, multiparity (OR, 0.45) and history of breast-feeding (OR, 0.38) decreased the development of osteoporosis in postmenopausal women. In women aged 49 to 54, breast-feeding was significantly protective, while low body mass index was most indicative of osteoporosis in women ages 55 to 64. Both previous fracture and low body mass index were associated with osteoporosis in women over age 64. The current results are consistent with other studies suggesting that previous fracture, low body weight, and use of anticoagulants increase the risk of osteoporosis. Our results also suggest that a history of pregnancy and breast-feeding protects against the development of postmenopausal osteoporosis, especially in women aged 49 to 54.

  10. Osteoporosis screening for men: are family physicians following the guidelines?

    Science.gov (United States)

    Cheng, Natalie; Green, Michael E

    2008-08-01

    To determine rates of screening for osteoporosis among men older than 65 years and to find out whether family physicians are following the recommendations of the Osteoporosis Society of Canada's 2002 Clinical Practice Guidelines for the Diagnosis and Management of Osteoporosis in Canada. Chart audit. The Family Medicine Centre at Hotel Dieu Hospital in Kingston, Ont. All male patients at the Family Medicine Centre older than 65 years for a total of 565 patients associated with 20 different physicians' practices. Rates of screening with bone mineral density (BMD) scans for osteoporosis, results of BMD testing, and associations between results of BMD testing and age. Of the 565 patients reviewed, 108 (19.1% of the study population) had received BMD testing. Rates of screening ranged from 0% to 38% in the 20 practices. Among 105 patients tested (reports for 3 patients were not retrievable), 15 (14.3%) were found to have osteoporosis, 43 (41.0%) to have osteopenia, and 47 (44.8%) to have normal BMD results. No significant association was found between BMD results and age. Screening rates were higher among men older than 75 years than among men aged 65 to 75 and peaked among those 85 to 89 years old. On average, only about 20% of male patients older than 65 years had been screened for osteoporosis, so most of these men were not being screened by BMD testing as recommended in the guidelines. Considering the relatively high rates of osteoporosis and osteopenia found in this study and the known morbidity and mortality associated with osteoporotic fractures in this population, higher rates of BMD screening and more widespread treatment of osteoporosis could prevent many fractures among these patients. Family physicians need to become more aware of the risk factors indicating screening, and barriers to screening and treatment of osteoporosis in men need to be identified and addressed.

  11. How should clinicians manage osteoporosis in ankylosing spondylitis?

    Science.gov (United States)

    Bessant, Rupa; Keat, Andrew

    2002-07-01

    Osteoporosis is a common complication of AS, with an incidence between 18.7% and 62%. The prevalence of osteoporosis is greater in males, and increases with increasing patient age and disease duration. Osteoporosis is also more common in patients with syndesmophytes, cervical fusion, and peripheral joint involvement. These variables are not all independent, as they may be indicators of disease duration. Osteoporosis in patients with AS is largely confined to the axial skeleton, in contrast to the pattern of osteoporosis seen in rheumatoid arthritis. BMD at the lumbar spine and femoral neck may be severely reduced, while most studies indicate that carpal and radial BMD remain within normal limits. The development of syndesmophytes in late AS can lead to difficulties in the use of DEXA scanning to determine lumbar BMD, as the extraspinal bone may obscure osteoporotic vertebrae. Under these circumstances more accurate assessment of lumbar BMD, and one that correlates better with femoral neck BMD, may be obtained by quantitative CT scanning or DEXA scanning of the lateral aspect of the L3 vertebra. Osteoporosis in AS significantly increases the risk of vertebral compression fractures within 5 years of the diagnosis of AS. The risk of a vertebral compression fracture occurring over a 30 year period following the diagnosis of AS is 14%, compared to 3.4% for population controls. In patients with vertebral osteoporosis relatively minor trauma, such as slipping, can lead to spinal fracture and dislocatior with subsequent damage to the spinal cord. There is a higher incidence of spinal cord injury following spinal fracture dislocations in patients with AS, and the resulting neurological deficit can range from mild sensory loss to complete paraplegia. Cytokines such as TNF-alpha and IL-6 may play an important part in the pathogenesis of osteoporosis in early AS, and IL-6 levels have been correlated with markers of disease activity and severity. In late AS, mechanical factors

  12. Case of Transient Osteoporosis of the Hip in Pregnancy

    Directory of Open Access Journals (Sweden)

    Hamza Sucuoğlu

    2014-12-01

    Full Text Available Transient osteoporosis of the hip is an uncommon disease, the cause is not known. It is usually seen in women in the third trimester of pregnancy and in middle-aged men. Patients present with acute, severe hip pain which generally resulting in gait disorder. Prognosis of transient osteoporosis of the hip is good. Within few months of appropriate conservative aproach and bed rest patient’s complains can be fully recovered. In this article; we present the clinical features, diagnosis and treatment options of patients presented to our clinic with severe bilateral hip pain during the third trimester of pregnancy diagnosed as transient osteoporosis accompanied by literature review.

  13. Adapted physical activity in the prevention and therapy of osteoporosis

    OpenAIRE

    Bošković Ksenija; Protić-Gava Branka; Grajić Mirko; Madić Dejan; Obradović Borislav; Tomašević-Todorović Snežana

    2013-01-01

    Introduction. Osteoporosis, a disease characterized by the progressive loss of bone tissue, is one of the most common complications of aging. Epidemiology. According to some calculations, there were 25% of women and 4% of men older than 50 years with osteoporosis in the world in 2010. It is assumed that the number of patients with osteoporosis will increase by 30% in every 10 years in the 21st century. There are many reasons for that: the world’s population is growing older, diet is get...

  14. OSTEOPOROSIS IN CALCIUM PYROPHOSPHATE CRYSTAL DEPOSITION DISEASE

    Directory of Open Access Journals (Sweden)

    S A Vladimirov

    2013-01-01

    Full Text Available Objective: to study the incidence of osteoporosis (OP in patients with calcium pyrophosphate crystal deposition disease (CPCDD. Subjects and methods. Eighty patients with CPCDD were examined. Bone mineral density (BMD of the forearm, lumbar spine, and femoral neck was determined by dual-energy X-ray absorptiometry. Laboratory diagnosis involved determination of the blood levels of C-reactive protein, parathyroid hormone, calcium, magnesium, and phosphorus and the daily urinary excretion of calcium and phosphates. Results. The patients with OP were significantly older than those with normal BMD and osteopenia. Forearm bones were the most common isolated location of OP and osteopenia. Injuries in the history, traumatic fractures, and the intake of diuretics were somewhat more common in the patients diagnosed with OP. The incidence of hyperparathyroidism did not differ significantly in the groups.

  15. Pregnancy associated osteoporosis--a case report.

    Science.gov (United States)

    Dytfeld, Joanna; Horst-Sikorska, Wanda

    2012-05-01

    Loss of bone mineral density (BMD)--usually temporary--occurs during pregnancy and lactation. Pregnancy associated osteoporosis (PAO) is an uncommon disease of unknown etiology. We present a case of a 35-year old woman with PAO, manifesting initially at the end of the first pregnancy as back pain. It reappeared in the second pregnancy four years later X-ray revealed multilevel compression fractures of Th12, L1, L2. DEXA showed L2-L4 T-score: -3.3 SD, hip T-score: -2.09 SD. Laboratory findings were irrelevant. She was put on antiresorptive treatment, calcium and vitamin D. Although there has been an improvement in BMD, the patient is a definite candidate for vertebral kyphoplasty due to disabling pain.

  16. Osteoarthritis and osteoporosis: what is the overlap?

    Science.gov (United States)

    Bultink, Irene E M; Lems, Willem F

    2013-05-01

    Osteoarthritis (OA) and osteoporosis (OP) are highly prevalent health problems, associated with considerable morbidity. In the past, attention was focused on a supposed inverse relationship between OA and OP, since both disorders usually affect the elderly, but were regarded to rarely coexist in a single person. However, recent studies have revealed several factors which contribute to the pathogenesis of both disorders. These insights might contribute to the development of shared new treatment options in the near future. Increased subchondral bone loss is a characteristic feature of OP and the early stage of OA, and this finding is the rationale for studies on the effect of anti-osteoporotic drugs in OA. In addition, inflammation and unfavourable body composition have been recognized as contributing factors for both disorders. Underweight is a risk factor for OP, while obesity stimulates the development of OA, by mechanical overloading of weight-bearing joints but also by supposed unfavourable effects of adipokines.

  17. Osteoporosis: new hope for the future.

    Science.gov (United States)

    Masi, L; Bilezikian, J P

    1997-01-01

    This article will review established and newer approaches to osteoporosis. With greater awareness of this major public health problem and highly sensitive, safe, and accurate measures of bone mass, it is now possible to identify women with osteoporosis well before they begin to suffer some of its devastating consequences. One of the most important approaches to therapy is prevention. Measures of importance relate to the establishment of peak bone mass in young adulthood. Along with issues of life style, adequate calcium intake looms as one of the important nutritional features of a program designed to establish peak bone mass. Calcium is also important later on in life to prevent bone loss and to help restore bone that might have been lost due to osteoporosis. Sufficient calcium intake is an essential component of any preventive regimen. New guidelines for optimal calcium intake are based upon the Consensus Development Conference that was held at the National Institutes of Health in June 1994. These guidelines recommended calcium intake somewhat higher than the official recommended dietary allowances (RDA) as published by the Food and Drug Administration. For women who are not yet menopausal as well as for those who are taking hormone replacement therapy (up to the age of 65) an intake of 1,000 mg daily is recommended. For women beyond the age of 65, as well as for women over 50 who choose not to take hormone replacement therapy, 1,500 mg of calcium a day are recommended. Along with sufficient calcium, it is important that vitamin D be sufficient in supply. Adequate vitamin D is essential for optimal dietary calcium absorption. In the United States, many factors are predisposing women to become less sufficient with respect to vitamin D stores. These factors include routine avoidance of sun, which is a major source of vitamin D; avoidance of milk, which is fortified with vitamin D; and physiological factors that make it more difficult for an older individual to

  18. Osteoporosis in Latin America: panel expert review

    Directory of Open Access Journals (Sweden)

    Patricia Clark

    2013-09-01

    Full Text Available Background. The Latin American region is undergoing a demographic and epidemiological transition, which is leading to an increase in chronic and degenerative diseases. Osteoporosis (OP and fragility fractures (FF are emerging as main causes of disease burden with great impact on health institutions. Purpose. This review article provides an updated overview of trends in the epidemiology and economic impact of OP and FF, as well as in diagnosis and available treatments in Latin America, including calcium, vitamin D and prevention programs. Methods. Expert panel. Conclusions. According to this review, there is a lack of epidemiological and economic information in the region. It is desirable to obtain information regarding quality of life in OP and FF as well as to highlight prevention as a tool to reduce FF.

  19. Recombinant parathormone and osteoporosis: a review article

    Directory of Open Access Journals (Sweden)

    Larijani B

    2010-12-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Osteoporosis is a condition characterized with reduced bone density and destruction of the bone structure. The ideal treatment aims to reduce the risk of fracture while improving the density and structure of the bone. Parathormone (PTH and its main analogue triparatide (rhPTH [1-34] is a new class of anabolic medications which accelerates the healing process in the fractured bone through improving bone formation and therefore is used for treating severe osteoporosis. The present review article was designed to report the history, different types, anabolic and catabolic effects, complications, indications and contraindications of the hormone.

  20. Premature menopause linked to CVD and osteoporosis.

    Science.gov (United States)

    Park, Claire; Overton, Caroline

    2010-03-01

    Premature menopause affects 1% of women under the age of 40, the usual age of the menopause is 51. Most women will present with irregular periods or no periods at all with or without climacteric symptoms. Around 10% of women present with primary amenorrhoea. A careful history and examination are required. It is important to ask specifically about previous chemotherapy or radiotherapy and to look for signs of androgen excess e.g. polycystic ovarian syndrome, adrenal problems e.g. galactorrhoea and thyroid goitres. Once pregnancy has been excluded, a progestagen challenge test can be performed in primary care. Norethisterone 5 mg tds po for ten days or alternatively medroxyprogesterone acetate 10 mg daily for ten days is prescribed. A withdrawal bleed within a few days of stopping the norethisterone indicates the presence of oestrogen and bleeding more than a few drops is considered a positive withdrawal bleed. The absence of a bleed indicates low levels of oestrogen, putting the woman at risk of CVD and osteoporosis. FSH levels above 30 IU/l are an indicator that the ovaries are failing and the menopause is approaching or has occurred. It should be remembered that FSH levels fluctuate during the month and from one month to the next, so a minimum of two measurements should be made at least four to six weeks apart. The presence of a bleed should not exclude premature menopause as part of the differential diagnosis as there can be varying and unpredictable ovarian function remaining. The progestagen challenge test should not be used alone, but in conjunction with FSH, LH and oestradiol. There is no treatment for premature menopause. Women desiring pregnancy should be referred to a fertility clinic and discussion of egg donation. Women not wishing to become pregnant should be prescribed HRT until the age of 50 to control symptoms of oestrogen deficiency and reduce the risks of osteoporosis and CVD.

  1. Running title: Treatment of postmenopausal osteoporosis.

    Directory of Open Access Journals (Sweden)

    Bülent Tiras

    2005-12-01

    Full Text Available Osteoporosis is characterized with low bone mass and deterioration of skeletal microarchitecture. It leads to a fragile bone and increased risk of fracture by minimal trauma. Today, osteoporotic fractures have become a major health concern. Therefore many different studies have been organized to enlighten basic pathology, and to investigate efficient therapeutic modalities. The change in the prescription attitudes in postmenopausal hormone replacement therapy (HRT increased the value of non-HRT therapies. The purpose of this review is to evaluate all therapeutic modalities which could be used in this setting by analyzing prospective randomized studies. By a general scope of view, the choice of treatment should be individualized with respect to age, risk factors,\tand concomitant disorders. In early menopause HRT can be used for women with severe vasomotor symptoms if there is no contraindication. Since no difference was noted between HRT and bisphosphonates, there is no need to combination regimens.\tAfter vasomotor symptoms are subsided, raloxifene can be used to the patients who have T score of below -2 without non-vertebral fracture. It is obvious that the most efficient therapies to prevent new osteoporotic fractures are bisphosphonates, strontium ranelate, and parathyroid hormone (PTH. PTH should not be used longer than 24 months. The first two large series showed that strontium ranelate prevents fractures very effectively. In addition the side effects of this unique medication is not higher than placebo which is one of the major advantage of it. Many series identified the important role of bisphosphonates in the prevention of osteoporosis related morbidities. Calcitonin has a role in patients having pain. Daily calcium and vitamin D supplement should be recommended to all patients, and diet and exercise programmes should be organized.

  2. New aspects of osteoporosis: Bone mineral content (BMC) measurement in osteoporosis associated with drugs, arthritis, and related conditions

    International Nuclear Information System (INIS)

    Gross, M.D.; Shapiro, B.

    1987-01-01

    Sensitive, non-invasive measurements of bone mineral content (BMC) provide the means to identify and characterize, prior to the development of symptoms, osteoporosis associated with drugs, rheumatoid arthritis, inflammatory bowel disease, diabetes mellitus, anorexia nervosa and immobilization. Moreover, BMC can be used to effectively screen populations at risk for the development of osteoporosis and longitudinal studies in individual patients can be used to guide effective anti-osteopenia therapy. This review will briefly detail recent BMC measurements in osteoporosis due to drugs, arthritis and related conditions. (orig.) [de

  3. New aspects of osteoporosis: Bone mineral content (BMC) measurement in osteoporosis associated with drugs, arthritis, and related conditions

    Energy Technology Data Exchange (ETDEWEB)

    Gross, M.D.; Shapiro, B.

    1987-02-01

    Sensitive, non-invasive measurements of bone mineral content (BMC) provide the means to identify and characterize, prior to the development of symptoms, osteoporosis associated with drugs, rheumatoid arthritis, inflammatory bowel disease, diabetes mellitus, anorexia nervosa and immobilization. Moreover, BMC can be used to effectively screen populations at risk for the development of osteoporosis and longitudinal studies in individual patients can be used to guide effective anti-osteopenia therapy. This review will briefly detail recent BMC measurements in osteoporosis due to drugs, arthritis and related conditions.

  4. The Ontario Energy Board's proposed new mandate

    International Nuclear Information System (INIS)

    Laughren, F.

    1998-01-01

    The Ontario Energy Board's proposed new mandate was reviewed. The role of the Board will be to regulate the monopoly delivery components of the electricity and natural gas industry and to smooth the transition to competition. The Board will monitor market performance and will encourage electricity and natural gas monopoly services to be compatible where possible. The Board will also assist local restructuring efforts when called upon do so and ensure that the marketplace operates efficiently and effectively. Gas marketers' licensing is scheduled to begin in early 1999. Licenses will also apply to the electric industry. The objectives of the proposed licensing, the regulatory requirements and the proposed regulatory approach are described

  5. Main coolant pump testing at Ontario Hydro

    International Nuclear Information System (INIS)

    Hartlen, R.

    1991-01-01

    This article describes Ontario Hydro Research Division's experience with a computerized data acquisition and analysis system for monitoring mechanical vibration in reactor coolant pumps. The topics covered include bench-marking of the computer system and the coolant pumps, signatures of normal and malfunctioning pumps, analysis of data collected by the monitoring system, simulation of faults, and concerns that have been expressed about data interpretation, sensor types and locations, alarm/shutdown limits and confirmation of nondestructive examination testing. This presentation consists of overheads only

  6. Ontario Power Generation Nuclear: results and opportunities

    International Nuclear Information System (INIS)

    Dermarkar, F.

    2006-01-01

    This paper describes the accomplishments of Ontario Power Generation (OPG) Nuclear and outlines future opportunities. OPG's mandate is to cost effectively produce electricity, while operating in a safe, open and environmentally responsible manner. OPG's nuclear production has been increasing over the past three years - partly from the addition of newly refurbished Pickering A Units 1 and 4, and partly from the increased production from Darlington and Pickering B. OPG will demonstrate its proficiency and capability in nuclear by continuing to enhance the performance and cost effectiveness of its existing operations. Its priorities are to focus on performance excellence, commercial success, openness, accountability and transparency

  7. The Ontario Hydro mortality surveillance programme

    International Nuclear Information System (INIS)

    Anderson, T.W.

    1985-01-01

    The Ontario Hydro mortality surveillance programme was the first such study established in any group of radiation workers. Copies of annual reports are available to senior officials of both management and union and to members of the general public. Apart from an elevated Standardized Mortality Ratio in the 15.0 - 19.9 cSv range, there is no suggestion of any rising cancer death rate with increased lifetime radiation dose. It should be noted that employees who had left before pensionable age were not included in the study. Results of the study are presented in tabular form

  8. Regional migratory osteoporosis: a review illustrated by five cases

    International Nuclear Information System (INIS)

    Toms, A.P.; Marshall, T.J.; Becker, E.; Donell, S.T.; Lobo-Mueller, E.M.; Barker, T.

    2005-01-01

    Regional migratory osteoporosis is an uncommon self-limiting disease characterized by an arthralgia which migrates between the weight-bearing joints of the lower limb. The radiological features of the disease obtained by conventional radiography, CT, MRI and radionuclide scintigraphy are illustrated by means of five case reports. These range from the most common presentation of sequential, proximal to distal spread in the lower limb to the rare intra-articular form, and disease involving the axial skeleton is also recognized. Clinical and radiographical features often overlap with those of diseases such as transient osteoporosis of the hip and transient bone marrow oedema syndrome, which is reflected in confusing terminology. Histological sampling is usually unnecessary; the radiological features are characteristic and the histological findings are not specific. Regional migratory osteoporosis is associated with systemic osteoporosis. This association is probably under-recognized, and has implications for the pathophysiology of the disease and for treatment

  9. Established Osteoporosis and Gaps in the Management: Review ...

    African Journals Online (AJOL)

    Annals of Medical and Health Sciences Research | Mar-Apr 2014 | Vol 4 | Issue 2 |. Address for ... More efforts are needed to fill this large gap in the correct management of osteoporosis related fractures .... Systematic review: Comparative.

  10. Radiographic Absorptiometry as a Screening Tool in Male Osteoporosis

    DEFF Research Database (Denmark)

    Hansen, S J; Nielsen, Morten M.; Ryg, J

    2009-01-01

    Background: Osteoporosis screening with dual-energy absorptiometry (DXA) is not recommended due to low diagnostic utility and costs. Radiographic absorptiometry (RA) determines bone mineral density (BMD) of the phalangeal bones of the hand and is a potential osteoporosis pre-screening tool. Purpose......: To determine the ability of RA to identify patients with osteoporosis in a male population. Material and Methods: As part of the Odense Androgen Study, we measured BMD of the intermediate phalanges of the second to fourth finger, lumbar spine (L2-L4), and total hip in 218 men aged 60-74 years (mean 68.8 years......), randomly invited from the population, using RA (MetriScan) and DXA (Hologic 4500-A). Osteopenia and osteoporosis were defined as a T-score of less than -1.0 and -2.5, respectively, in the hip and/or lumbar spine. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were computed...

  11. Pathogenesis, diagnosis and therapy of osteoporosis in the elderly

    Energy Technology Data Exchange (ETDEWEB)

    Minne, H.W.; Wuester, C.; Ziegler, R.

    1987-02-01

    Bone mass reduction without static insufficiency of the skeleton are the signs of osteopenia resulting in osteoporosis together with signs of static insufficiency. One third of all women during menopause suffer from type I osteoporosis because of increased bone mineral turnover compared to type II osteoporosis of the elderly. The reasons for bone mineral loss are related to nutrition and estrogen deficiency, in addition to further risk factors. Treatment of osteoporosis is possible by use of fluorides besides physical activity, in addition to calcium and vitamin D/sub 3/. Calcitonins may be added. Monitoring of therapeutic efficiency is possible by use of dual photon absorptiometry together with roentgenographic control of the vertebral size in order to exclude compression of vertebrae as a cause of bone mineral concentration increase.

  12. Epidemiology of Osteoporosis and Osteoporotic Fractures in South Korea

    Directory of Open Access Journals (Sweden)

    Young-Kyun Lee

    2013-06-01

    Full Text Available Several epidemiologic studies suggested that osteoporosis and osteoporotic fractures are not uncommon in South Korea. However, these previous cohort studies had limitations that may have influenced their results and the generalizability of the study conclusions, including small sample sizes, inclusion of only women, enrollment of participants from specific areas, and nonrandom selection of participants. Recently, epidemiologic studies using a nationwide claim register have been performed to overcome these limitations through collaboration between the Korean Society of Bone and Mineral Research and Health Insurance Review Assessments. Our review of the Korean Nationwide-database Osteoporosis Study could be helpful to obtain accurate incidence and prevalence estimations of osteoporosis and osteoporosis-related fractures in Korea.

  13. Women's lived experiences of learning to live with osteoporosis

    DEFF Research Database (Denmark)

    Hansen, Carrinna A; Abrahamsen, Bo; Konradsen, Hanne

    2017-01-01

    qualitative interviews were conducted with fifteen recently diagnosed Danish women. A longitudinal design was chosen since this allows an investigation of the perspective over time. The interviews were conducted in the period of March 2011 to August 2012. Data were analyzed using a phenomenological......BACKGROUND: A vast amount of literature exists concerning pharmaceutical adherence in osteoporosis. However, the process of learning to live with osteoporosis over time remains largely unknown. The purpose of this study was to gain a deeper understanding of the continued process of how women learn...... to live with osteoporosis. Our objective was to explore what characterizes women's experiences of living with osteoporosis during the first year after diagnosis, when patients are prescribed anti-osteoporotic treatment, without having experienced an osteoporotic fracture. METHODS: Forty-two narrative...

  14. Inflammatory eye reactions with bisphosphonates and other osteoporosis medications

    DEFF Research Database (Denmark)

    Clark, Emma M; Durup, Darshana

    2015-01-01

    Inflammatory eye reactions (IERs) are rare but have been associated with medications to treat osteoporosis. The aim of this review is to summarize the current literature on the association between IERs and specific medications to treat osteoporosis (bisphosphonates, selective estrogen receptor...... of the information available is from spontaneous case reports and case series reporting associations between bisphosphonates and IERs. No case reports describe IERs after other anti-osteoporosis medications. Importantly, some case reports describe recurrence of the IER after affected patients were rechallenged...... with the same or another bisphosphonate, and that no reported cases resolved without discontinuation of the bisphosphonate. However, three large population-based cohort studies have shown conflicting results between osteoporosis treatments and IERs, but overall these studies suggest that IERs may actually...

  15. Nebivolol might be Beneficial in Osteoporosis Treatment: A Hypothesis

    African Journals Online (AJOL)

    Erah

    cytokines termed. 'bone remodeling'. Osteoporosis is characterized by low bone mass and microarchitectural ... due to direct reduction of reactive oxygen species (ROS) that is ... bone marrow-derived mesenchymal stem cell cultures40.

  16. Pathogenesis, diagnosis and therapy of osteoporosis in the elderly

    International Nuclear Information System (INIS)

    Minne, H.W.; Wuester, C.; Ziegler, R.

    1987-01-01

    Bone mass reduction without static insufficiency of the skeleton are the signs of osteopenia resulting in osteoporosis together with signs of static insufficiency. One third of all women during menopause suffer from type I osteoporosis because of increased bone mineral turnover compared to type II osteoporosis of the elderly. The reasons for bone mineral loss are related to nutrition and estrogen deficiency, in addition to further risk factors. Treatment of osteoporosis is possible by use of fluorides besides physical activity, in addition to calcium and vitamin D 3 . Calcitonins may be added. Monitoring of therapeutic efficiency is possible by use of dual photon absorptiometry together with roentgenographic control of the vertebral size in order to exclude compression of vertebrae as a cause of bone mineral concentration increase. (orig.) [de

  17. Recent genetic discoveries in osteoporosis, sarcopenia and obesity.

    Science.gov (United States)

    Urano, Tomohiko; Inoue, Satoshi

    2015-01-01

    Osteoporosis is a skeletal disorder characterized by low bone mineral density (BMD) and an increased susceptibility to fractures. Evidence from genetic studies indicates that BMD, a complex quantitative trait with a normal distribution, is genetically controlled. Genome-wide association studies (GWAS) as well as studies using candidate gene approaches have identified single-nucleotide polymorphisms (SNPs) that are associated with BMD, osteoporosis and osteoporotic fractures. These SNPs have been mapped close to or within genes including those encoding WNT/β-catenin signaling proteins. Understanding the genetics of osteoporosis will help to identify novel candidates for diagnostic and therapeutic targets. Genetic factors are also important for the development of sarcopenia, which is characterized by a loss of lean body mass, and obesity, which is characterized by high fat mass. Hence, in this review, we discuss the genetic factors, identified by genetic studies, which regulate the body components related to osteoporosis, sarcopenia, and obesity.

  18. Poor knowledge about osteoporosis in learned Indian women.

    Science.gov (United States)

    Pande, K; Pande, Sonali; Tripathi, S; Kanoi, R; Thakur, A; Patle, S

    2005-05-01

    The present study was done to assess knowledge about osteoporosis in learned Indian women, identify their source of knowledge and to study the correlation of level of knowledge with other variables. A total of 73 female staff members (average age 44.7 years) of a teaching institute completed the Osteoporosis Questionnaire (OPQ). The mean +/- SD of total score for the sample was 4.1 +/- 4.1 (range -8 to 15; maximum possible score 20). The correct definition of osteoporosis was given by 74%, but there was general lack of awareness in all the areas assessed. There was statistically significant difference in the total score depending on the faculty of education, with staff members from the science faculty having the maximum mean score (p lack of knowledge about osteoporosis in learned Indian women and also the need for increased involvement of medical professionals in patient education.

  19. The Prevalence of Osteoporosis among Antenatal Clinic Attendees ...

    African Journals Online (AJOL)

    2018-01-30

    Jan 30, 2018 ... a high prevalence of osteoporosis among pregnant women in Southeast Nigeria. This may be due to the predominant poor adherence and low dose of calcium .... India,[26,27] the study participants in this study were only.

  20. Profile of teriparatide in the management of postmenopausal osteoporosis

    Directory of Open Access Journals (Sweden)

    Andrea Sikon

    2010-03-01

    Full Text Available Andrea Sikon1, Pelin Batur21Cleveland Clinic Lerner COM, Cleveland Clinic, Cleveland, OH, USA; 2Cleveland Clinic Lerner COM, Cleveland Clinic Independence, Independence, OH, USAAbstract: One out of every 2 women within postmenopause are at risk of fracture due to osteoporosis. Fortunately, a growing arsenal of therapies is becoming available to treat this disease and prevent fracture. A new class of anabolic agents has emerged within the last decade that brought with it a new concept in osteoporosis therapy: building new stronger bone rather than simply inhibiting bone turnover. Evidence is accumulating to understand how to best utilize these new agents, and which patients benefit most. This article will review the effectiveness, risks, timing and clinical uses of teriparatide in postmenopausal osteoporosis.Keywords: osteoporosis, menopause, teriparatide

  1. Comparing the feed-in tariff incentives for renewable electricity in Ontario and Germany

    International Nuclear Information System (INIS)

    Mabee, Warren E.; Mannion, Justine; Carpenter, Tom

    2012-01-01

    The development of feed-in tariff (FIT) programs to support green electricity in Ontario (the Green Energy and Green Economy Act of 2009) and Germany (the Erneuerbare Energien-Gesetz of 2000) is compared. The two policies are highly comparable, offering similar rates for most renewable electricity technologies. Major differences between the policies include the level of differentiation found in the German policy, as well as the use of a price degression strategy for FIT rates in Germany compared to an escalation strategy in Ontario. The German renewable electricity portfolio is relatively balanced, compared to Ontario where wind power dominates the portfolio. At the federal level, Canada does not yet have a policy similar to the European Directive on Renewable Energy, and this lack may impact decisions taken by manufacturers of renewable technologies who consider establishing operations in the province. Ontario's Green Energy and Green Economy Act could be benefit from lessons in the German system, especially with regard to degression of feed-in tariff rates over time, which could significantly reduce payments to producers over the course of a contract, and in turn encourage greater competitiveness among renewable power providers in the future. - Highlights: ► We compare two jurisdictions that utilize feed-in tariffs to support renewable electricity. ► Complementary policy such as mandated renewable energy use in conjunction with tariffs increases certainty for investors. ► Targeted incentives in the form of adders can deliver more diversity in renewable generation capacity. ► Degression of tariff rates delivers renewable generation capacity at lower cost.

  2. The Durham Strategic Energy Alliance : building a roadmap to meet Ontario's present and future energy needs

    International Nuclear Information System (INIS)

    Gabriel, K.; Lindeblom, D.

    2006-01-01

    The challenge facing Ontario in gaining access to affordable, flexible and reliable energy at a time when energy demand is escalating was discussed. The Durham Strategic Energy Alliance (DSEA) was created in 2005 to position Ontario's Durham Region as a Canadian leader in timely, sustainable and reliable energy solutions. Durham employs about 10,000 workers directly in the energy industry. The region also produces nearly 30 per cent of the province's power from local generating stations. It is also home to an energy focused teaching and research institution at the University of Ontario Institute of Technology. The DSEA is composed of business, industry, government and academic institutions committed to taking action on advancing energy solutions in all aspects of the energy life-cycle. Members have a stake in promoting sustainable energy solutions in energy supply and generation, manufacturing of energy solutions, transmission, distribution, conservation and/or consumption of all forms of energy. Since its creation, the DSEA has taken measures to exploit the energy opportunities in Durham Region and plans to significantly expand its activities in the future, particularly in building commercialization capabilities through an energy cluster. New links and formalized networks will be established to achieve this goal. Innovative networks will be developed to connect Durham's academic community with business, industry and energy clusters which are developing globally. The overall DSEA strategy is to develop Durham's energy cluster so that it evolves quickly into Ontario's energy commercialization center. There are three areas where such strategy will be recognized: energy technology adoption/demonstration centre; energy technology adoption officer; and, energy cluster outreach/network. 1 fig

  3. Osteoporosis management in older patients who experienced a fracture

    Directory of Open Access Journals (Sweden)

    Oertel MJ

    2016-08-01

    Full Text Available Mark J Oertel,1 Leland Graves,1 Eyad Al-Hihi,2 Vincent Leonardo,3 Christina Hopkins,2 Kristin DeSouza,2 Rajib K Bhattacharya1 1Division of Endocrinology, Metabolism and Genetics, Department of Medicine, 2Department of Internal Medicine, 3Department of Enterprise Analytics, University of Kansas Medical Center, Kansas City, KS, USA Background: Fractures in older patients are common, morbid, and associated with increased risk of subsequent fractures. Inpatient and outpatient management and treatment of fractures can be costly. With more emphasis placed on quality care for Medicare beneficiaries, we studied if patients were receiving proper screening for osteoporosis and treatment after diagnosis of fracture. This study aims to determine if adequate screening and treatment for osteoporosis occurs in the postfracture period.Methods: A retrospective analysis of Medicare beneficiaries aged 67 years or older was gathered from a single institution in both inpatient and outpatient visits. Based on International Classification of Diseases ninth revision codes, primary diagnosis of fractures of neck and trunk, upper limb, and lower limb were obtained in addition to current procedural terminology codes for fracture procedures. We studied patients who had been screened for osteoporosis with a bone mineral study or received osteoporosis treatment after their fracture.Results: Medicare beneficiaries totaling 1,375 patients were determined to have an inclusion fracture between June 1, 2013 and November 30, 2014. At the time of our analysis on December 1, 2014, 1,219 patients were living and included in the analysis. Of these patients, 256 (21.0% either received osteoporosis testing with bone mineral density or received treatment for osteoporosis. On sex breakdown, 208/820 (25.4% females received proper evaluation or treatment of osteoporosis in comparison to 48/399 (12.0% males. This is in comparison to the Centers for Medicare and Medicaid Services’ national

  4. Bisfosfonatos: Aplicaciones Actuales en Osteoporosis y Cáncer

    OpenAIRE

    Poma Carmona, Augusto; Gutiérrez, Guiselle; Casas, Jorge

    2014-01-01

    Bisphosphonates are antiresorptive agents with high affinity for hidroxiapatite crystals. They are not degraded by pyrophosphatases. Their main indications are treatment of post-menopausic osteoporosis, corticosteroid-induced osteoporosis, Paget´s disease, neoplasm-induced hypercalcemia and osteolytic bone disease by cancer. Los bisfosfonatos son compuestos antirresortivos con alta afinidad por los cristales de hidroxiapatita y no son degradados por las pirofosfatasas. Sus principales indi...

  5. Osteoporosis in men: epidemiology and treatment with denosumab

    Directory of Open Access Journals (Sweden)

    Sidlauskas KM

    2014-04-01

    Full Text Available Kristel M Sidlauskas, Emily E Sutton, Michael A Biddle Albany College of Pharmacy and Health Sciences-Vermont Campus, Colchester, VT, USA Abstract: Osteoporosis is a major public health care concern. Although often described as a disease affecting postmenopausal women, researchers and clinicians have emphasized its prevalence in men in recent years. The National Osteoporosis Foundation has stated that up to 25% of men over the age of 50 years will experience a fracture due to osteoporosis. Men who suffer from a major fracture have higher mortality rates than women. Pharmacologic therapy options for treating osteoporosis are limited for men as compared with women, so each medication approved for use in this population represents an important clinical option. In September 2012, the US Food and Drug Administration approved a new indication for denosumab to increase bone mass in men with osteoporosis at high risk for fracture. Denosumab is a fully human monoclonal antibody and novel antiresorptive agent that works by binding receptor activator of nuclear factor kappa-β ligand (RANKL and inhibiting the signaling cascade that causes osteoclast maturation, activity, and survival. Ultimately, denosumab suppresses bone turnover and increases bone mineral density in both trabecular and cortical bone. Approval for treating osteoporosis in men was based on data from the ADAMO trial which displayed efficacy in increasing bone mineral density at the lumbar spine, total hip, femoral neck, hip trochanter, and one-third radius. Studies indicate that denosumab is effective and safe, and has superior adherence rates and patient satisfaction. Although long-term data and further research on fracture reduction rates in men should be explored, at this time denosumab is one of several appropriate first-line treatment options for men with osteoporosis. Keywords: denosumab, osteoporosis, men, treatment

  6. Studies of osteoporosis in Shanghai, China, using isotope related techniques

    International Nuclear Information System (INIS)

    Zhang Yuanxun; Zhang Yongpeng; Qin Junfa; Li Deyi; Ma Jixiao; Hua Qian

    1996-01-01

    Using Hologic QDR-2000 DEXA, the BMD determinations of subjects suffering from osteoporosis and normal persons are in progress in Shanghai, China. A primary correlation between the kidney disease and the osteoporosis has been obtained. The studies of multi elemental distribution in cancellous bone of femoral head are also performed by PIXE. According to IAEA Co-ordinated Research Programme (CRP), a further working arrangement has been planned. (author)

  7. Molecular Mechanisms of Obesity-Induced Osteoporosis and Muscle Atrophy

    OpenAIRE

    Roy, Bipradas; Curtis, Mary E.; Fears, Letimicia S.; Nahashon, Samuel N.; Fentress, Hugh M.

    2016-01-01

    Obesity and osteoporosis are two alarming health disorders prominent among middle and old age populations, and the numbers of those affected by these two disorders are increasing. It is estimated that more than 600 million adults are obese and over 200 million people have osteoporosis worldwide. Interestingly, both of these abnormalities share some common features including a genetic predisposition, and a common origin: bone marrow mesenchymal stromal cells. Obesity is characterized by the ex...

  8. Managing an oak decline crisis in Oakville, Ontario: lessons learned

    Science.gov (United States)

    Peter A. Williams; John W. McNeil; Kurt W. Gottschalk; Robert A. Haack

    2013-01-01

    The town of Oakville, Ontario, is located along the north shore of Lake Ontario between Toronto and Hamilton. In the fall of 2002, significant oak (Quercus spp.) mortality was observed at Oakville's Iroquois Shoreline Woods Park, an environmentally significant forest remnant noted for its oak-dominated forests. Investigations suggested that oak...

  9. Cooperatives and the State: The Case of Ontario

    Directory of Open Access Journals (Sweden)

    Rachel Laforest

    2011-01-01

    Full Text Available In the early 2000s, the cooperative movement in Ontario came together in order to lobby its provincial government for active cooperative development support programs. Momentum was building for these types of programs. Already, many provincial governments had implemented active support programs in their jurisdiction. Despite having one of the largest cooperative sectors in Canada, Ontario was lagging behind. This article assesses the progress of the efforts of the Ontario cooperative movement to date. It details how the Ontario cooperative movement developed a sectoral identity for itself and framed its objectives in an effort to strengthen its relationship with the Ontario government. / Le mouvement coopératif en Ontario s'est rassemblé au début des années 2000 afin de faire pression sur le gouvernement provincial pour qu'il développe des programmes de soutient actif pour coopératives. Déjà plusieurs gouvernements provinciaux avaient mis en place de telles politiques. L'Ontario tardait malgré le fait qu'il avait un des plus grands secteurs coopératifs au Canada. Cet article examine le progrès qu'a connu le mouvement coopératif en Ontario dans ses efforts. Il décrit comment le mouvement coopératif a construit une identité sectorielle autour de laquelle il a pu ancrer ses demandes auprès du gouvernement ontarien.

  10. Colonoscopy resource availability and colonoscopy utilization in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Colleen Webber

    2017-04-01

    The availability of colonoscopy resources improved in Ontario between 2007 and 2013. However, the geographic variation in resource availability and findings that higher colonoscopy resource availability is associated with higher colonoscopy utilization suggest that certain areas of the province may be under-resourced. These areas may be appropriate targets for efforts to improve colonoscopy capacity in Ontario.

  11. Education Governance Reform in Ontario: Neoliberalism in Context

    Science.gov (United States)

    Sattler, Peggy

    2012-01-01

    This paper explores the relationship between neoliberal ideology and the discourse and practice of education governance reform in Ontario over the last two decades. It focuses on changes in education governance introduced by successive Ontario governments: the NDP government from 1990 to 1995, the Progressive Conservative government from 1995 to…

  12. Province of Ontario nuclear emergency plan. Pt. 1

    International Nuclear Information System (INIS)

    1986-06-01

    The Province of Ontario Nuclear Emergency Plan has been developed pursuant to Section 8 of the Emergency Plans Act, 1983. This plan replaces the Province of Ontario Nuclear Contingency Off-Site Plan (June 1980) which is no longer applicable. The wastes plan includes planning, preparation, emergency organization and operational responsibilities and policy

  13. The assessment of osteoporosis risk factors in Iranian women compared with Indian women

    Directory of Open Access Journals (Sweden)

    Chakravarty Devlina

    2008-02-01

    Full Text Available Abstract Background Osteoporosis is an important public health problem in older adults. It is more common in postmenopausal women and not only gives rise to morbidity but also markedly diminishes the quality of life in this population. There is lack of information about the risk factor of osteoporosis in developing countries. In this study we aimed to assess the risk factors for osteoporosis in postmenopausal women from selected BMD centers of two developing Asian countries (Iran and India. Methods This study is a multicenter interview-based study conducted in selected hospitals and health centers from urban areas in Iran and India. The case group included postmenopausal osteoporotic women who were identified as patients with bone density higher than 2.5 SD below average of young normal bone density (in L1–L4 spine region interest and/or total femoral region by using DEXA method. The controls were chosen from postmenopausal women with normal bone density (in L1–L4 spine and total femoral regions using DEXA method matching in age groups was strategy of choice. The sample sizes included from Iran a total of 363 subjects (178 osteoporotic and 185 normal and from India a total of 354 subjects (203 osteoporotic and 151 normal. Results The significant (p Lower education defined as less than class 12 or nil college (2.1 (2.7, duration of menopause greater than 5 years: (2.2 (1.4, Menarche age (after 14 years: (1.9 (1.6, Menopause age (before 45 years: (1.1 (2, Parity more than 3: (1.1 (1, Bone and joint problem (2.3 (2.2. Calcium supplementation (0.6 and HRT (0.4 were shown as protective factors and steroid therapy (3.3 was found as a risk factor in Iran. Calcium supplementation more than 1 year (0.3 was shown as a protective factor in India. Pure vegetarianism: (2.2 and Red meat consumption more than 4 times per week (1.4 was shown as a risk factor in Indian and Iranian subjects respectively. Regular consumption of Soya (0.3, almond (0.5, fish (0

  14. Therapeutical Approach of Osteoporosis — a Multidisciplinary Issue

    Directory of Open Access Journals (Sweden)

    Camelia Gliga

    2013-08-01

    Full Text Available Osteoporosis is the most frequent systemic disease of the bone, that affects elderly, mainly women in menopause. It can be defined by lowering of bone mass and microarchitectural deterioration of the bone tissue, resulting in an increased bone fragility. Main complications of osteoporosis are fractures of the vertebrae, hips and forearm. In view of its large variety of causes and manifestations, diagnostic and therapeutical approach in osteoporosis represents a multidisciplinary issue. The accurate diagnosis of osteoporosis is based on a method that measures the bone mineral density, expressed by the T-score, using dual energy X-ray absorptiometry, so called DXA. Lately, in practice in order for establishing the risk of osteoporosis and osteoporotic fracture the FRAX tool is increasingly used (The Fracture Risk Assessment. Treatment of osteoporosis is complex involving non-pharmacological and pharmacological measures. Non-pharmacological methods include preventive measures like exercise, external hip protectors, increase of dietary intake of calcium, vitamin D and proteins, especially in elderly, over 65 years. Pharmacological measures are represented by different types of drugs, including biphosphonates, bone formation stimulatory drugs, agents with new mechanisms of action, hormone replacement therapy and they will be indicated only after a detailed clinical and paraclinical examination of the patient. Regardless of the chosen pharmacological measure, periodical follow-up of efficacy, side-effects and complications of antiosteoporotic treatment, by clinical examination and laboratory investigations targeting bone remodelling, is strongly indicated.

  15. Whole-body vibration exercise in postmenopausal osteoporosis

    Directory of Open Access Journals (Sweden)

    Magdalena Weber-Rajek

    2015-01-01

    Full Text Available The report of the World Health Organization (WHO of 2008 defines osteoporosis as a disease characterized by low bone mass and an increased risk of fracture. Postmenopausal osteoporosis is connected to the decrease in estrogens concentration as a result of malfunction of endocrine ovarian function. Low estrogens concentration causes increase in bone demineralization and results in osteoporosis. Physical activity, as a component of therapy of patients with osteoporosis, has been used for a long time now. One of the forms of safe physical activity is the vibration training. Training is to maintain a static position or execution of specific exercises involving the appropriate muscles on a vibrating platform, the mechanical vibrations are transmitted to the body of the patient. According to the piezoelectric theory, pressure induces bone formation in the electrical potential difference, which acts as a stimulant of the process of bone formation. Whole body vibration increases the level of growth hormone and testosterone in serum, preventing sarcopenia and osteoporosis. The aim of this study was to review the literature on vibration exercise in patients with postmenopausal osteoporosis based on the PubMed and Medline database. While searching the database, the following key words were used ‘postmenopausal osteoporosis’ and ‘whole-body vibration exercise’.

  16. Theoretical and experimental investigation of multispectral photoacoustic osteoporosis detection method

    Science.gov (United States)

    Steinberg, Idan; Hershkovich, Hadas Sara; Gannot, Israel; Eyal, Avishay

    2014-03-01

    Osteoporosis is a widespread disorder, which has a catastrophic impact on patients lives and overwhelming related to healthcare costs. Recently, we proposed a multispectral photoacoustic technique for early detection of osteoporosis. Such technique has great advantages over pure ultrasonic or optical methods as it allows the deduction of both bone functionality from the bone absorption spectrum and bone resistance to fracture from the characteristics of the ultrasound propagation. We demonstrated the propagation of multiple acoustic modes in animal bones in-vitro. To further investigate the effects of multiple wavelength excitations and of induced osteoporosis on the PA signal a multispectral photoacoustic system is presented. The experimental investigation is based on measuring the interference of multiple acoustic modes. The performance of the system is evaluated and a simple two mode theoretical model is fitted to the measured phase signals. The results show that such PA technique is accurate and repeatable. Then a multiple wavelength excitation is tested. It is shown that the PA response due to different excitation wavelengths revels that absorption by the different bone constitutes has a profound effect on the mode generation. The PA response is measured in single wavelength before and after induced osteoporosis. Results show that induced osteoporosis alters the measured amplitude and phase in a consistent manner which allows the detection of the onset of osteoporosis. These results suggest that a complete characterization of the bone over a region of both acoustic and optical frequencies might be used as a powerful tool for in-vivo bone evaluation.

  17. Knowledge about osteoporosis prevention among women screened by bone densitometry

    Directory of Open Access Journals (Sweden)

    Mariola Janiszewska

    2016-07-01

    Full Text Available Introduction : Osteoporosis is an illness characterized by the handicapped endurance of the bones, causing an increased risk of fracture. Aim of the study was to establish the level of knowledge about osteoporosis prevention among women screened by bone densitometry and to answer the question whether the level of knowledge is dependent on socio-demographic factors. Material and methods: The research was realized by means of a survey method, a poll technique in 2014. The study involved 292 women aged 51-83. The examined women were patients undergoing bone densitometry in the healthcare centres in Lublin. The osteoporosis knowledge test (OKT, revised 2011 by Phyllis Gendler was used as a research tool. Gathered material was subject to descriptive and statistical analysis. Tukey’s test, t-Student test and variance analysis (ANOVA were all applied. A statistical significance level was set at  = 0.05. Results and conclusions : Respondents presented the basic exercise knowledge (M = 9.97 and low knowledge concerning risk factors, screening and treatment of osteoporosis (M = 7.87. The calcium knowledge remained on an average level (M = 14.03. Better educated women, city inhabitants as well as women having very good or good social and welfare conditions showed a significantly higher level of knowledge about osteoporosis prevention. Even women undergoing bone densitometry examination present insufficient knowledge about osteoporosis prevention.

  18. Independent power and cogeneration in Ontario's new competitive electricity market

    International Nuclear Information System (INIS)

    Barnstable, A.G.

    1999-01-01

    The factors influencing the initial market pricing in the early years of Ontario's new electricity market were discussed with particular insight on the potential for near term development of independent power and cogeneration. The major factors influencing prices include: (1) no increase in retail prices, (2) financial restructuring of Ontario Hydro, (3) the Market Power Mitigation Agreement, (4) tighter power plant emissions standards, and (5) an electricity supply and demand balance. Generation competition is not expected to influence market pricing in the early years of the new electricity market. Prices will instead reflect the restructuring decisions of the Ontario government. The decision to have Ontario Power Generation Inc. (OPGI) as a single generator for Ontario Hydro's generation assets will ensure that average spot market pricing in the early market years will be close to a 3.8 c/kWh revenue cap

  19. Deregulation, privatization and the Ontario power failure

    International Nuclear Information System (INIS)

    2003-09-01

    The Canadian Union of Public Employees (CUPE) has examined the history of deregulation of the electricity industry in the United States and presents lessons that could be learned from the California electricity crisis, the collapse of Enron, and the massive blackout that occurred in August 2003 across Ontario and northeastern United States. Unlike the United States, Canada's electricity system is mostly publicly owned and operated. This report emphasized that the need for public investment in the electricity system is greater than ever, and offers suggestions on how to strengthen the Canadian electricity system. It examines the attempts made to deregulate and privatize the electricity system in Ontario, Alberta, New Brunswick and British Columbia and exposes the reality of price caps and the debt of public utilities. It demonstrates that privatization has failed to provide a safe, reliable, affordable and adequate supply of electricity. The report claims that profit-seeking power producers want to keep supply and demand in their favour to sell electricity at the highest possible price. In addition to emphasizing the need for public investment in the electricity system, this report emphasizes the need for Canadian electricity cooperation, with particular mention of the large energy supplies in Manitoba and Quebec. 37 refs

  20. Public perceptions of energy issues in Ontario

    International Nuclear Information System (INIS)

    2004-11-01

    In October 2004, the Environics Research Group conducted a telephone survey of 608 adult Ontarians to collect information on matters regarding energy; consumer confidence and protection; responsibilities of the Ontario Energy Board; and consumer information preferences. This report summarizes the key findings of the survey. According to the survey, the most important electricity and natural gas issue was identified as being price and cost issues, followed by reliability of supply, conservation, keeping utilities publicly owned, finding renewable sources of energy, and over-consumption. The survey revealed that Ontarians show much interest in conserving energy to save money, to protect the environment and ensure future energy supply, but they are generally sceptical that their interests are being protected on electricity and natural gas price issues. At least 9 in 10 Ontarians consider the tasks of the Ontario Energy Board to be important. The majority of Ontarians prefer to receive energy conservation information through the mail and from public regulators over a government department or a company. 10 tabs

  1. Ontario Energy Board 2005 survey of stakeholders

    International Nuclear Information System (INIS)

    2006-01-01

    A survey was conducted among members of the Ontario Energy Board's (OEB) various stakeholder groups in order to measure the Board's performance and to help the Board identify areas for improvement in the way it operates. The survey included telephone interviews with consumer groups, advocacy groups, the energy sector, electricity and gas distributors, financial organizations as well as other stakeholders. The topics addressed in the survey were key energy issues and priority issues; the perceived role of the OEB; the OEB strengths and weaknesses; the importance of various OEB functions; the overall performance of the OEB; an evaluation of OEB communication with industry and consumers; an evaluation of service quality; and, awareness and participation in regulatory policy initiatives. Respondents used a 10-point scale in their evaluation. This report presented the main findings and their interpretations. Major stakeholders identified electricity supply issues and the price of electricity as being the most important energy issues facing Ontario. This report also presented the detailed findings for questions regarding the lack of generator capacity, policy stability, the coal phase out program, electricity blackouts, conservation, electricity restructuring and investment. The major finding of the survey was an overall increase in satisfaction with the OEB's performance. It was suggested that the OEB can improve in timeliness and providing consumer information. The major areas of strength were found to be its professionalism in conducting hearings and the fairness of the Board's decisions and regulations. tabs

  2. Coal-fired electricity generation in Ontario

    International Nuclear Information System (INIS)

    2001-03-01

    This report examines coal-fired electricity generation in Ontario and recommends actions to be taken by the provincial government to protect the environment. The recommendations are also designed to assist in making decisions about the environmental safeguards needed for a competitive electricity industry. The report examines air emissions from coal-fired generating plants in the larger context of air pollution in the province; summarizes background information on key air pollutants; provides an individual profile of all coal-fired power stations in the province; and benchmarks Ontario's emissions performance by comparing it with 19 nearby U.S. jurisdictions. Current and proposed environmental controls for fossil fuel power generation in the province are elaborated. Options for maximizing environmental performance and the framework for strengthening environmental protection are reviewed. The report also contains a series of findings and recommendations which are deemed necessary before the moratorium imposed on the sale of coal-fired electricity plants imposed in May 2000, can be lifted. tabs., figs

  3. Immunization with FSHβ fusion protein antigen prevents bone loss in a rat ovariectomy-induced osteoporosis model

    Energy Technology Data Exchange (ETDEWEB)

    Geng, Wenxin; Yan, Xingrong; Du, Huicong; Cui, Jihong; Li, Liwen, E-mail: liven@nwu.edu.cn; Chen, Fulin, E-mail: chenfl@nwu.edu.cn

    2013-05-03

    Highlights: •A GST-FSH fusion protein was successfully expressed in E. coli. •Immunization with GST-FSH antigen can raise high-titer anti-FSH polyclonal sera. •Anti-FSH polyclonal sera can neutralize osteoclastogenic effect of FSH in vitro. •FSH immunization can prevent bone loss in a rat osteoporosis model. -- Abstract: Osteoporosis, a metabolic bone disease, threatens postmenopausal women globally. Hormone replacement therapy (HTR), especially estrogen replacement therapy (ERT), is used widely in the clinic because it has been generally accepted that postmenopausal osteoporosis is caused by estrogen deficiency. However, hypogonadal α and β estrogen receptor null mice were only mildly osteopenic, and mice with either receptor deleted had normal bone mass, indicating that estrogen may not be the only mediator that induces osteoporosis. Recently, follicle-stimulating hormone (FSH), the serum concentration of which increases from the very beginning of menopause, has been found to play a key role in postmenopausal osteoporosis by promoting osteoclastogenesis. In this article, we confirmed that exogenous FSH can enhance osteoclast differentiation in vitro and that this effect can be neutralized by either an anti-FSH monoclonal antibody or anti-FSH polyclonal sera raised by immunizing animals with a recombinant GST-FSHβ fusion protein antigen. Moreover, immunizing ovariectomized rats with the GST-FSHβ antigen does significantly prevent trabecular bone loss and thereby enhance the bone strength, indicating that a FSH-based vaccine may be a promising therapeutic strategy to slow down bone loss in postmenopausal women.

  4. Pharmacological treatment of osteoporosis in the oldest old

    Directory of Open Access Journals (Sweden)

    Vandenbroucke A

    2017-07-01

    Full Text Available A Vandenbroucke,1 FP Luyten,2,3 J Flamaing,4 E Gielen3,4 1Clinical Department of Internal Medicine, UZ Leuven, 2Skeletal Biology and Engineering, Department of Development and Regeneration, KU Leuven, 3Center for Metabolic Bone Disease, UZ Leuven, 4Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium Abstract: The incidence of osteoporotic fractures increases with age. Consequently, the global prevalence of osteoporotic fractures will increase with the aging of the population. In old age, osteoporosis is associated with a substantial burden in terms of morbidity and mortality. Nevertheless, osteoporosis in old age continues to be underdiagnosed and undertreated. This may, at least partly, be explained by the fact that evidence of the antifracture efficacy of osteoporosis treatments comes mainly from randomized controlled trials in postmenopausal women with a mean age of 70–75 years. However, in the last years, subgroup analyses of these landmark trials have been published investigating the efficacy and safety of osteoporosis treatment in the very elderly. Based on this evidence, this narrative review discusses the pharmacological management of osteoporosis in the oldest old (≥80 years. Because of the high prevalence of calcium and/or vitamin D deficiency in old age, these supplements are essential in the management of osteoporosis in the elderly people. Adding antiresorptive or anabolic treatments or combinations, thereof, reduces the risk of vertebral fractures even more, at least in the elderly with documented osteoporosis. The reduction of hip fracture risk by antiresorptive treatments is less convincing, which may be explained by insufficient statistical power in some subanalyses and/or a higher impact of nonskeletal risk factors in the occurrence of hip fractures. Compared with younger individuals, a larger absolute risk reduction is observed in the elderly because of the higher

  5. Osteoporosis - "a silent killer". A review of the current literature from clinician and physiotherapist perspective

    Directory of Open Access Journals (Sweden)

    Janusz Kocjan

    2015-07-01

    SUMMARY             Osteoporosis is a disease characterized by low bone mass and deterioration of bone structure that causes bone fragility and increases the risk of fracture. Individuals with osteoporosis are at high risk of suffering one or more fractures, which are often physically debilitating and can potentially lead to a downward spiral in physical and mental health. Article attempts to discuss this issue from the clinical and rehabilitation perspective. Following contents were included: diagnosis, types of osteoporosis, epidemiology, burden of osteoporosis, types of fractures, treatment and rehabilitation of osteoporosis.   Key words: osteoporosis, porous bone, low bone mass, silent disease.

  6. Clinical and therapeutic aspects of osteoporosis

    Energy Technology Data Exchange (ETDEWEB)

    Compston, Juliet [University of Cambridge School of Clinical Medicine, Box 157, Department of Medicine, Addenbrookes Hospital, Hills Road, Cambridge CB2 2QQ (United Kingdom)], E-mail: jec1001@cam.ac.uk

    2009-09-15

    Osteoporosis is characterized by reduced bone mass and alteration in bone architecture, resulting in increased fracture risk. These fractures are a major cause of morbidity and mortality in the elderly and impose a huge economic burden on health services. Oestrogen deficiency plays a major role in the pathogenesis of bone loss and fracture in both women and men. Other pathogenetic factors include reduced physical activity and vitamin D insufficiency. A range of options is available for the prevention of fractures in high risk postmenopausal women. These include the bisphosphonates, strontium ranelate, raloxifene and parathyroid hormone peptides. Because of their broad spectrum of demonstrated anti-fracture efficacy, alendronate, risedronate, zoledronate and strontium ranelate are generally considered as front-line options for most women. The optimum duration of treatment has not been established but re-evaluation of risk and the need for continued therapy after 5 years of treatment may be appropriate. Compliance and persistence with long-term treatment is poor but may be improved by less frequent dosing regimens.

  7. Clinical and therapeutic aspects of osteoporosis

    International Nuclear Information System (INIS)

    Compston, Juliet

    2009-01-01

    Osteoporosis is characterized by reduced bone mass and alteration in bone architecture, resulting in increased fracture risk. These fractures are a major cause of morbidity and mortality in the elderly and impose a huge economic burden on health services. Oestrogen deficiency plays a major role in the pathogenesis of bone loss and fracture in both women and men. Other pathogenetic factors include reduced physical activity and vitamin D insufficiency. A range of options is available for the prevention of fractures in high risk postmenopausal women. These include the bisphosphonates, strontium ranelate, raloxifene and parathyroid hormone peptides. Because of their broad spectrum of demonstrated anti-fracture efficacy, alendronate, risedronate, zoledronate and strontium ranelate are generally considered as front-line options for most women. The optimum duration of treatment has not been established but re-evaluation of risk and the need for continued therapy after 5 years of treatment may be appropriate. Compliance and persistence with long-term treatment is poor but may be improved by less frequent dosing regimens.

  8. Prevalence of antibodies to Leptospira in wild mammals trapped on livestock farms in Ontario, Canada.

    Science.gov (United States)

    Allen, Samantha E; Ojkic, Davor; Jardine, Claire M

    2014-07-01

    To determine the prevalence and diversity of Leptospira serogroups circulating in wildlife on farms in Ontario, we tested samples from 51 raccoons (Procyon lotor), seven skunks (Mephitis mephitis), four rats (Rattus norvegicus), and three opossums (Didelphis virginiana) that were trapped on 27 livestock (swine [Sus scrofa], cattle [Bos taurus]) farms in 2010. Seventeen of 51 raccoons (33%; 95% confidence interval [CI], 21-48%) sampled were positive for at least one Leptospira serogroup using the microscopic agglutination test. None of the other 14 animals had detectable Leptospira antibodies. On swine farms, 13 of 30 raccoons (43%; 95% CI, 27-61%) were antibody positive, and on cattle farms, four of 21 raccoons (19%; 95% CI, 8-40%) were positive. Leptospira antibody prevalence in raccoons did not differ between swine and cattle farms. Raccoons were positive to serovars representative of serogroups Grippotyphosa, Australis, Icterohaemorrhagiae, and Pomona and were negative to serovars of serogroups Autumnalis, Canicola, and Sejroe. The prevalence of Leptospira antibodies in raccoons in this study is similar to what has been reported previously; however, the diversity of serogroups was higher in this study than what has been reported in raccoons from an urban area of Ontario, Canada. Understanding the prevalence and distribution of Leptospira serogroups in wildlife in Ontario, Canada, is important for the development and maintenance of appropriate disease management strategies in humans, livestock, and companion animals.

  9. Countering school bullying: An analysis of policy content in Ontario and Saskatchewan

    Directory of Open Access Journals (Sweden)

    Ginette Diane Roberge

    2011-08-01

    Full Text Available The incidence of extreme school violence as a direct consequence of bullying among peers, exacerbated by vast media attention, has caused educational institutions worldwide to put bullying intervention and prevention strategies into operation. This study focused on an overview of two provincewide antibullying incentives in the Canadian provinces of Ontario and Saskatchewan, and an analysis of the quality of their respective antibullying policies. An itemized list of beneficial practices for bullying intervention and prevention originated from Smith, Smith, Osborn and Samara (2008’s scoring scheme. The scoring scheme was adapted to the current study by linking research-based program elements that have been found to be effective in reducing school bullying to a content analysis of both provincial frameworks. The final scoring scheme comprised a total of 39 criterions, divided into five categories: Defining Bullying Behaviors, Establishing a Positive School Climate, Disseminating, Monitoring and Reviewing Policy, Reporting and Responding to Bullying, and Involving the Broader Community. Results showed that policies contained a total average of 60% of the criterions in Ontario, and 59% in Saskatchewan. The conclusion of this study observes from policy lenses key essentials of bullying intervention and prevention initiatives in elementary and secondary educational settings. Recommendations are proposed to bridge the gap between areas that have received extensive attention and areas that have received less treatment in bullying intervention and prevention endeavors, using the content of Ontario and Saskatchewan policies as a basis for discussion.

  10. Ageism in Studies on the Management of Osteoporosis.

    Science.gov (United States)

    McGarvey, Caoimhe; Coughlan, Tara; O'Neill, Desmond

    2017-07-01

    To review the literature to assess whether the fact that osteoporosis is chiefly considered a disease of the older population was reflected in research in the area of the management of osteoporosis and to determine the extent of ageism in studies on the management of osteoporosis. Review. All randomized control trials on the management of osteoporosis entered in the Cochrane Library Database that reported mean age were included. Exclusion criteria were also examined. Of 284 randomized control trials identified, 102 were eligible for inclusion. Older adult trail participants. Mean age of participants and exclusion criteria used were analyzed. The mean age of all participants was 64.0, despite the fact that the average age at hip fracture is 83 for women and 84 for men. Overall, the mean age of those presenting with hip fractures is 84.8. Twenty-four (23%) of the 102 trials used older age as an exclusion factor. Other exclusion factors were long time since menopause, impaired cardiac or pulmonary function, dependent in ambulation, any severe comorbidity, dementia or any cognitive impairment, recent history of peptic ulcer disease or erosive gastric disease, uncontrolled hypertension, and psychiatric illness. These data show a distinct difference between the mean age of participants in studies of the management of osteoporosis and the mean age of those presenting with hip fractures. Given that osteoporosis is the leading cause of hip fractures, this finding could have a significant effect on future studies in this area. It would follow that future research should include a cohort of an age that is more reflective of those most likely to experience the adverse effects of osteoporosis. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  11. The Relationship between H. pylori Infection and Osteoporosis in Japan

    Directory of Open Access Journals (Sweden)

    Daisuke Asaoka

    2014-01-01

    Full Text Available Background and Objective. H. pylori infection causes a chronic inflammation in the gastric mucosa. However, this local inflammation may result in extra-digestive conditions. Our aim is to investigate the relationship between H. pylori infection and osteoporosis in Japan. Methods. This cross-sectional study was conducted among outpatients at the Juntendo University Hospital between 2008 and 2014. Participants for patient profile, H. pylori infection status, comorbidity, internal medical therapies, lumbar dual-energy X-ray absorptiometry (DXA, and bone turnover marker were collected and upper gastrointestinal endoscopy for reflux esophagitis, hiatal hernia, peptic ulcer disease (PUD, and endoscopic gastric mucosal atrophy (EGA was performed. The diagnosis of osteoporosis was performed in accordance with the Japanese criteria. We investigated risk factors of osteoporosis. Results. Of the eligible 200 study subjects, 41 cases were of osteoporosis. Bivariate analysis showed that age, being female, BMI, alcohol, smoking, H. pylori, bone-specific ALP, PUD, and EGA were related to osteoporosis. Multivariate analysis showed that age (OR 1.13; 95%CI 1.07–1.20, being female (OR 4.77; 95%CI 1.78–12.77, BMI (OR 0.79; 95%CI 0.68–0.92, H. pylori (OR 5.33; 95%CI 1.73–16.42, and PUD (OR 4.98; 95%CI 1.51–16.45 were related to osteoporosis. Conclusions. H. pylori infection may be a risk factor of osteoporosis in Japan.

  12. Osteoporosis in men: epidemiology and treatment with denosumab.

    Science.gov (United States)

    Sidlauskas, Kristel M; Sutton, Emily E; Biddle, Michael A

    2014-01-01

    Osteoporosis is a major public health care concern. Although often described as a disease affecting postmenopausal women, researchers and clinicians have emphasized its prevalence in men in recent years. The National Osteoporosis Foundation has stated that up to 25% of men over the age of 50 years will experience a fracture due to osteoporosis. Men who suffer from a major fracture have higher mortality rates than women. Pharmacologic therapy options for treating osteoporosis are limited for men as compared with women, so each medication approved for use in this population represents an important clinical option. In September 2012, the US Food and Drug Administration approved a new indication for denosumab to increase bone mass in men with osteoporosis at high risk for fracture. Denosumab is a fully human monoclonal antibody and novel antiresorptive agent that works by binding receptor activator of nuclear factor kappa-β ligand (RANKL) and inhibiting the signaling cascade that causes osteoclast maturation, activity, and survival. Ultimately, denosumab suppresses bone turnover and increases bone mineral density in both trabecular and cortical bone. Approval for treating osteoporosis in men was based on data from the ADAMO trial which displayed efficacy in increasing bone mineral density at the lumbar spine, total hip, femoral neck, hip trochanter, and one-third radius. Studies indicate that denosumab is effective and safe, and has superior adherence rates and patient satisfaction. Although long-term data and further research on fracture reduction rates in men should be explored, at this time denosumab is one of several appropriate first-line treatment options for men with osteoporosis.

  13. Proceedings of the Ontario Petroleum Institute's 48. annual conference : Ontario oil, gas and storage conference

    International Nuclear Information System (INIS)

    2009-01-01

    This conference discussed issues related to Ontario's petroleum industry and evaluated the province's potential hydrocarbon plays. Geological studies of interest to oil and gas operators were presented along with storage opportunities for hydrocarbons in underground formations. Regulatory issues related to the environmental impacts of oil and gas operations on soil and groundwater were reviewed, and various mitigation options for treating soils impacted by hydrocarbons were discussed. New technologies currently being used in Ontario's petroleum industry were presented together with various investment and exploration opportunities. An economic update of recent oil and gas activities in the region was also presented. The conference was divided into 7 sessions, and featured 17 presentations, of which 11 have been catalogued separately for inclusion in this database. tabs., figs.

  14. Waste management practices in Ontario`s workplaces: An emerging industrial ecology

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-09-01

    Describes a study commissioned to evaluate employee attitudes and behaviours with respect to participation in workplace initiatives in waste diversion/reduction, to examine management initiatives related to waste diversion and reduction/recycling/reuse, and to report on Ontario Ministry of Environment & Energy activities related to industrial, commercial, and institutional (ICI) waste diversion activities. Linkages between management and employees, management and government, and ICI activities and government were also studied. The study methodology included a literature review, a series of interviews with key stakeholders, industry associations, and waste management companies, and a series of 12 case studies spanning major industrial sectors in Ontario. Issues addressed in the study include the factors that trigger waste diversion activities by ICI establishments, barriers to the initiation of waste diversion practices, and the social aspects of waste reduction/recycling/reuse practices.

  15. Osteoporosis-related life habits and knowledge about osteoporosis among women in El Salvador: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Martinez-Garcia Sandra

    2004-08-01

    Full Text Available Abstract Background Osteoporosis is a systemic skeletal disorder, characterized by reduced bone mass, deterioration of bone structure, increased bone fragility, and increased fracture risk. It is more frequent to find among women than men at a 4:1 ratio. Evidence suggests that to adopt changes on some life habits can prevent or delay development of osteoporosis. Several osteoporosis-risk factors have been confirmed in the US and western Europe, but in El Salvador there are neither reliable epidemiological statistics about this skeletal disorder nor studies addressing osteoporosis-risk factors in women. The aim of this study was to determinate the extent of osteoporosis knowledge, the levels of both daily calcium intake and weight-bearing physical activity, and the influence of several osteoporosis-risk factors on these variables in three age groups of Salvadorean women. Methods In this exploratory cross-sectional study, an osteoporosis knowledge assessment questionnaire incluiding a food frequency and a physical activity record section were used to collect data and it was delivered through a face-to-face interview. A convenience sample (n = 197 comprised of three groups of women aged 25–35 years, 36–49 years, and over 49 years was taken. Among-group comparisons of means were analyzed by two-way ANOVA. To determinate the overall influence of osteoporosis-risk factors, the multivariate analysis was used. Results Study results indicated that better educated women had more knowledge about osteoporosis than women with a low education level, regardless of age, even though this knowledge was rather fair. Older women got more weight-bearing physical activity at home and less at place of employment than reported by the younger women; however, neither group performed sufficient high-intensity WBPA to improve bone mass. Regardless of age, the most women consumed 60% or less than the Dietary Reference Intake of calcium and depend on household income

  16. Cross currents : hydroelectricity and the engineering of northern Ontario

    Energy Technology Data Exchange (ETDEWEB)

    Manore, J.L. [Calgary Univ., AB (Canada)

    1999-05-01

    The history of hydroelectric development in northern Ontario was reviewed and analysed with special emphasis on the developments along the Mattagami and Abitibi Rivers. The objective was to examine the important factors that shaped modern hydroelectric development in Canada. System builders, the privately owned Nesbitt Thomson Company, the publicly owned Hydro Electric Power Corporation of Ontario and the eventual evolution of the single power system under Ontario Hydro are chronicled. Broad historical themes such as the technological impacts, regionalism, indigenous rights, plus environmental and economic issues are examined, in addition to an appreciation of the importance of electricity in the manufacturing sector of Ontario, the impact of hydroelectric development on the northern environment and on the northern First Nations, who rely on rivers for their subsistence. Until fairly recently, government policies and interpretations of law often excluded the recognition of Aboriginal uses of river systems, thereby limiting First Nations` peoples ability to practice traditional ways of life. In essence, the book is an account of how the northeastern power system in Ontario shaped the social, political and natural environments and how the development of northeastern power sources by southern power developers shaped the regional interactions between Ontario`s north and south. refs., figs.

  17. Lessons learned implementing a province-wide smoking cessation initiative in Ontario's cancer centres.

    Science.gov (United States)

    Evans, W K; Truscott, R; Cameron, E; Peter, A; Reid, R; Selby, P; Smith, P; Hey, A

    2017-06-01

    A large body of evidence clearly shows that cancer patients experience significant health benefits with smoking cessation. Cancer Care Ontario, the provincial agency responsible for the quality of cancer services in Ontario, has undertaken a province-wide smoking cessation initiative. The strategies used, the results achieved, and the lessons learned are the subject of the present article. Evidence related to the health benefits of smoking cessation in cancer patients was reviewed. A steering committee developed a vision statement for the initiative, created a framework for implementation, and made recommendations for the key elements of the initiative and for smoking cessation best practices. New ambulatory cancer patients are being screened for their smoking status in each of Ontario's 14 regional cancer centres. Current or recent smokers are advised of the benefits of cessation and are directed to smoking cessation resources as appropriate. Performance metrics are captured and used to drive improvement through quarterly performance reviews and provincial rankings of the regional cancer centres. Regional smoking cessation champions, commitment from Cancer Care Ontario senior leadership, a provincial secretariat, and guidance from smoking cessation experts have been important enablers of early success. Data capture has been difficult because of the variety of information systems in use and non-standardized administrative and clinical processes. Numerous challenges remain, including increasing physician engagement; obtaining funding for key program elements, including in-house resources to support smoking cessation; and overcoming financial barriers to access nicotine replacement therapy. Future efforts will focus on standardizing processes to the extent possible, while tailoring the approaches to the populations served and the resources available within the individual regional cancer programs.

  18. Influence of gastrointestinal events on treatment of osteoporosis in Asia-Pacific women: Perspectives from physicians in the MUSIC OS-AP study.

    Science.gov (United States)

    Modi, A; Ebeling, P R; Lee, M S; Min, Y K; Mithal, A; Yang, X; Baidya, S; Sen, S; Sajjan, S

    2017-12-01

    The objectives of the physician survey component of the MUSIC OS-AP study were to describe physicians' approaches to treatment of women with postmenopausal osteoporosis and to understand the influence of gastrointestinal (GI) events on treatment in clinical practice. Physicians were recruited from 5 Asia-Pacific countries. Questionnaires collected information about physicians' standard practices for treatment of patients with osteoporosis, as well as their perspectives on the influence of GI events on osteoporosis treatment approaches. A total of 59 physicians participated in the study. The most frequently prescribed or recommended treatments were vitamin D (84% of patients), calcium (82%), and oral bisphosphonates (59%). When choosing a medication for treatment-naïve patients, GI sensitivity was often or always a factor for 79% of physicians. Among physicians not prescribing pharmacologic treatment, a mean of 18% of non-prescriptions were due to GI sensitivity. For patients with pre-existing GI conditions, physicians most frequently ranked use of non-oral osteoporosis medication as the first treatment strategy (47%), followed by co-prescription with a proton pump inhibitor or other gastro-protective agent (31%). For patients developing GI symptoms after starting pharmacologic treatment, the most frequently first-ranked management strategy was to check if patients were taking their osteoporosis medication correctly as prescribed (64%), followed by temporary discontinuation of the medication (i.e., a drug holiday) until GI events have resolved (31%) and co-prescription with a proton pump inhibitor or other gastroprotective agent (24%). These results suggest that GI events influence the prescribing practices of physicians in the Asia-Pacific region and sometimes result in non-treatment of women with osteoporosis.

  19. "Better safe than sorry": a qualitative content analysis of participant's perspectives of fall-related concerns and balance in older women with osteoporosis after balance training.

    Science.gov (United States)

    Halvarsson, Alexandra; Ståhle, Agneta; Halén, Carolina; Roaldsen, Kirsti Skavberg

    2015-07-03

    To explore how older women with osteoporosis perceive fall-related concerns and balance in daily life after having participated in balance training. Explorative study. Semi-structured interviews were conducted with 19 women (66-84 years), with osteoporosis recruited from an ongoing RCT; participants were asked about their perceived fall-related concerns and balance. Interviews were taped and transcribed verbatim. Data were analyzed using inductive qualitative content analysis. One underlying theme emerged: "Internalized risk perception related to experience of bodily fragility", and three manifest categories: empowerment, safety and menace. A dynamic process between the categories was found, in which contextual and personal factors influenced perceptions of fall-related concerns and balance, i.e. winter season may lead a person who is highly empowered and/or uses active strategies into a situation of perception of menace and avoidance of activity. To cope with the fragility caused by osteoporosis informants had an internalized risk perception that protected them against possible threats and harm. Informants perceived improved empowerment and self-efficacy after participation in balance training. They resumed activities and became more active and independent in daily life using safety precautions and fall-prevention strategies. Depending on contextual factors, some situations still invoked fear and led to avoidance. Implication for Rehabilitation Risk awareness protecting against possible threats and harms seems to be internalized in older women living with osteoporosis. When designing fall prevention programs, it is important to recognize that contextual and personal factors have a major influence on how older women with osteoporosis perceive fall-related concerns and balance. Perception of fragility and risk seems to be a significant problem for older women with osteoporosis and health-care providers should encourage their patients to participate in tailored

  20. The Efficacy of Key Performance Indicators in Ontario Universities as Perceived by Key Informants

    Science.gov (United States)

    Chan, Vivian

    2015-01-01

    The Ontario Ministry of Education and Training's Task Force on University Accountability first proposed key performance indicators (KPIs) for colleges and universities in Ontario in the early 1990s. The three main KPIs for Ontario universities are the rates of (1) graduation, (2) employment, and (3) Ontario Student Assistance Program loan default.…

  1. Ontario Hydro nuclear - challenges of the future

    International Nuclear Information System (INIS)

    Field, R.

    1996-01-01

    The challenges facing Ontario Hydro Nuclear (OHN), as understood at the time of the conference, are discussed. OHN had many strengths to build on in preparing for the competition ahead, including: extremely competitive production costs, strong technical capabilities, advantages of multiple units, environmental advantages favoring nuclear, strong public support, and improving station performance. Even with these advantages, OHN faced the difficult challenge of improving overall performance in the face of a large debt burden, coupled with the reinvestment demands of aging units at Pickering A and Bruce A. At the time of the conference, Bruce 2 had already been shut down, because the cost of retubing it and replacing its boilers could not be justified. The ''drive to nuclear excellence'' involves the simultaneous achievement of top performance in safety, reliability and cost; and to this end, changes were being made to reverse the trends indicated by disappointing ''peer reviews''

  2. Physician recruitment in Ontario Provincial Psychiatric Hospitals.

    Science.gov (United States)

    Draper, R; Galbraith, D; Frost, B

    1989-11-01

    Recruitment of Physicians/Psychiatrists to staff the Ontario Provincial Psychiatric Hospitals remains an ongoing problem despite the introduction of measures such as University Affiliation and Incentive Grants. Historically there has been heavy reliance upon Foreign Medical Graduates (GOFM's) who have been denied the possibility of professional mobility and advancement because of restrictive licences. Recent changes in regulations have severely restricted the recruitment of GOFM's. During 1987, details of all physicians employed in the provincial hospitals during the preceeding five years were entered into a computerized data base. This paper presents some initial analyses which indicate that Canadian graduates have provided low levels of service, especially outside major urban centres, quite insufficient to replace the GOFM's. These findings raise urgent social and professional concerns.

  3. Implementation plan for smart meters in Ontario

    International Nuclear Information System (INIS)

    2004-01-01

    This paper presents Ontario Energy Board's implementation plan to install 800,000 smart meters by December 31, 2007. The objective is to help consumers control their electricity bills through conservation and demand response. The three conditions that will change power consumption habits are price changes in response to demand and supply forces; the ability of consumers to see and respond to the price signals; and, a measurement of the response so that consumers get credit for their actions. This paper identifies the mandatory technical requirements for smart meters and the support operations of distributors. It sets priorities, identifies barriers and regulatory mechanisms for cost recovery. It also discusses options for ownership of the meters. 18 refs., 1 tab., 2 figs

  4. Oil heritage district : Lambton County Ontario

    Energy Technology Data Exchange (ETDEWEB)

    Shearer, W. [Wendy Shearer Landscape Architect, Kitchener, ON (Canada)

    2009-07-01

    This paper discussed a project conducted to assess the cultural heritage values of oil field equipment in Lambton County, Ontario. Oil was discovered in the region in 1858, after which a boom and bust cycle of exploration created a large rural-industrial landscape. The region now contains a unique collection of historic oil equipment. The region's industrial footprint is interwoven with village settlements, agricultural settlements, and a railway and road network linking the region to remote refineries. Oil wells in the region still operate using a jerker line system developed in the early twentieth century. The operational oil wells are subject to fluctuating oil prices and environmental protection requirements. The project presents a rare opportunity to place industrial heritage conservation directly in the hands of business operators and regulators, while also functioning as part of a living community. 2 figs.

  5. Ontario Hydro's integrated air management plan

    International Nuclear Information System (INIS)

    Kalvins, A.K.; Brown, D.; Camacho, F.; Howes, H.; Jantzi, B.; Lin, X.; Lui, P.; Melo, O.T.; Mortimer, W.P.; Reuber, B.

    1992-01-01

    Ontario Hydro is developing an integrated air management plan as a tool for comparing the environmental impacts of fossil-fuel power generation options. The goal is to relate equipment, location, emissions, and impacts and to identify the optimum way to manage the utility's fossil generation system in view of upcoming environmental regulations and public expectations. The eight steps of the plan are briefly described: definition of power generation scenarios (upgrading, conversion to natural gas, non-utility generation, alternative technologies); estimation of emissions for each generation and fuel option studied; identification of impact of air emissions on building materials, agriculture, forests, lakes, and fisheries; modelling of air emissions dispersion; quantification of damage to pollution receptors; quantification of full fuel cycle effects; and comparison of the scenarios. The scenario having the lowest overall environmental impact involved upgrading the existing fossil-fuel system with additional air emissions controls and two integrated gasification combined cycle plants. 9 refs., 3 figs., 3 tabs

  6. Sulphate deposition by precipitation into Lake Ontario

    Energy Technology Data Exchange (ETDEWEB)

    Shaw, R W; Whelpdale, D M

    1973-01-01

    Measurements of sulphate concentration in precipitation from individual snow storms of several hours duration in the western Lake Ontario region indicate that approximately 9-66 mg/M/sub 2/ of SO/sub 4//sup 2 -/ is being deposited into the lake per storm. This amount is up to several times more than daily average values over long periods found by other workers. Using a mean sulphate concentration of 4 mg/l and an annual accumulation of precipitation of 760 mm, the yearly sulphate deposition by precipitation is about 0.1% of the total mass of sulphate in the lake; however, more significantly, it is of the same order of magnitude as that discharged directly into the lake by industry.

  7. Forecasting Ontario's blood supply and demand.

    Science.gov (United States)

    Drackley, Adam; Newbold, K Bruce; Paez, Antonio; Heddle, Nancy

    2012-02-01

    Given an aging population that requires increased medical care, an increasing number of deferrals from the donor pool, and a growing immigrant population that typically has lower donation rates, the purpose of this article is to forecast Ontario's blood supply and demand. We calculate age- and sex-specific donation and demand rates for blood supply based on 2008 data and project demand between 2008 and 2036 based on these rates and using population data from the Ontario Ministry of Finance. Results indicate that blood demand will outpace supply as early as 2012. For instance, while the total number of donations made by older cohorts is expected to increase in the coming years, the number of red blood cell (RBC) transfusions in the 70+ age group is forecasted grow from approximately 53% of all RBC transfusions in 2008 (209,515) in 2008 to 68% (546,996) by 2036. A series of alternate scenarios, including projections based on a 2% increase in supply per year and increased use of apheresis technology, delays supply shortfalls, but does not eliminate them without active management and/or multiple methods to increase supply and decrease demand. Predictions show that demand for blood products will outpace supply in the near future given current age- and sex-specific supply and demand rates. However, we note that the careful management of the blood supply by Canadian Blood Services, along with new medical techniques and the recruitment of new donors to the system, will remove future concerns. © 2012 American Association of Blood Banks.

  8. Nurse case-manager vs multifaceted intervention to improve quality of osteoporosis care after wrist fracture: randomized controlled pilot study.

    Science.gov (United States)

    Majumdar, S R; Johnson, J A; Bellerose, D; McAlister, F A; Russell, A S; Hanley, D A; Garg, S; Lier, D A; Maksymowych, W P; Morrish, D W; Rowe, B H

    2011-01-01

    Few outpatients with fractures are treated for osteoporosis in the years following fracture. In a randomized pilot study, we found a nurse case-manager could double rates of osteoporosis testing and treatment compared with a proven efficacious quality improvement strategy directed at patients and physicians (57% vs 28% rates of appropriate care). Few patients with fractures are treated for osteoporosis. An intervention directed at wrist fracture patients (education) and physicians (guidelines, reminders) tripled osteoporosis treatment rates compared to controls (22% vs 7% within 6 months of fracture). More effective strategies are needed. We undertook a pilot study that compared a nurse case-manager to the multifaceted intervention using a randomized trial design. The case-manager counseled patients, arranged bone mineral density (BMD) tests, and prescribed treatments. We included controls from our first trial who remained untreated for osteoporosis 1-year post-fracture. Primary outcome was bisphosphonate treatment and secondary outcomes were BMD testing, appropriate care (BMD test-treatment if bone mass low), and costs. Forty six patients untreated 1-year after wrist fracture were randomized to case-manager (n = 21) or multifaceted intervention (n = 25). Median age was 60 years and 68% were female. Six months post-randomization, 9 (43%) case-managed patients were treated with bisphosphonates compared with 3 (12%) multifaceted intervention patients (relative risk [RR] 3.6, 95% confidence intervals [CI] 1.1-11.5, p = 0.019). Case-managed patients were more likely than multifaceted intervention patients to undergo BMD tests (81% vs 52%, RR 1.6, 95%CI 1.1-2.4, p = 0.042) and receive appropriate care (57% vs 28%, RR 2.0, 95%CI 1.0-4.2, p = 0.048). Case-management cost was $44 (CDN) per patient vs $12 for the multifaceted intervention. A nurse case-manager substantially increased rates of appropriate testing and treatment for osteoporosis in

  9. Osteopenia and osteoporosis in postmenopausal women. Assessment by radiogrammetric measurement

    International Nuclear Information System (INIS)

    Celiktas, M.; Aikimbaev, K.S.; Soyupak, S.; Binokay, F.; Kozanoglu, E.

    2002-01-01

    Purpose: To compare the ability of the medial cortical thickness ratio to the width of the second metacarpal bone at the midshaft (MCR) in discriminating patients as normal, osteopenic or osteoporotic. Material and Methods: MCR was calculated from radiographs of 120 postmenopausal women. By dual-energy X-ray absorptiometry, the mineral density was measured in the lumbar spine, the wrist and the femoral neck. Patients were grouped in accordance with the diagnostic criteria of WHO on the basis of t-scores. MCR values were compared with t-scores and the ability of the MCR technique in discriminating the patient groups was evaluated. Results: Analysis of radiogrammetric data revealed significant differences in MCR value between the 3 groups. The MCR was lower in patients with osteoporosis and osteopenia compared with the normal group. The mean value of MCR was also slightly lower in patients with osteoporosis than in those with osteopenia. Accuracy assessment (ROC analysis) of MCR in the discrimination of patients with osteoporosis showed that test accuracy was acceptable, but less accurate than spinal, wrist and femoral neck t-scores. Compared with t-scores, this test was found to fairly discriminate those with and without osteopenia. Conclusion: The MCR method can discriminate patients as osteoporotic or normal. However, it seems that the MCR method should not be used for decisions concerning treatment of osteoporosis because of its low accuracy and thereby a risk for misclassification. Bone mineral density osteoporosis osteopenia radiogrammetry

  10. Consensus and controversy regarding osteoporosis in the pediatric population.

    Science.gov (United States)

    Bachrach, Laura Keyes

    2007-09-01

    To review current consensus and controversy surrounding the diagnosis and treatment of osteoporosis in childhood and adolescence. The medical literature was reviewed with emphasis on the importance of early skeletal health, risk factors for bone fragility, and the diagnosis and management of children at risk for osteoporosis. Childhood and adolescence are critical periods for optimizing bone growth and mineral accrual. Bone strength is determined by bone size, geometry, quality, and mass-variables that are influenced by genetic factors, activity, nutrition, and hormones. For children with genetic skeletal disorders or chronic disease, bone growth and mineral accrual may be compromised, increasing the lifetime risk of osteoporosis. The goal for the clinician is to identify children at greatest risk for future fragility fracture. Bone densitometry and turnover markers are challenging to interpret in children. Prevention and treatment of bone fragility in children are less well established than in adults. Optimizing nutrition and activity may not restore bone health, but the drug armamentarium is limited. Sex steroid replacement has not proven effective in restoring bone mass in patients with anorexia nervosa or exercise-associated amenorrhea. Bisphosphonates can increase bone mass and may reduce bone pain and fractures, most convincingly in patients with osteogenesis imperfecta. Further studies are needed to establish the safety, efficacy, and optimal drug, duration, and dosage in pediatric patients. Bone health during the first 2 decades contributes to the lifetime risk of osteoporosis. Further research is needed to develop evidence-based recommendations for the diagnosis and treatment of osteoporosis in childhood.

  11. Adolescent pregnancy is associated with osteoporosis in postmenopausal women.

    Science.gov (United States)

    Cho, Geum Joon; Shin, Jung-Ho; Yi, Kyong Wook; Park, Hyun Tae; Kim, Tak; Hur, Jun Young; Kim, Sun Haeng

    2012-04-01

    Adolescence is a critical time of life to accumulate bone for peak bone mass. Factors that may interfere with bone mass accrual during this period may increase the risk of osteoporosis. Several studies have reported that pregnancy during adolescence has detrimental effects on bone mass measurements after pregnancy. However, less is known about how adolescent pregnancy affects bone mineral density (BMD) and osteoporosis after menopause. The aim of this study was to evaluate the association between adolescent pregnancy and osteoporosis in postmenopausal Korean women. We conducted a cross-sectional study of 719 postmenopausal women, all of whom were enrolled in the Korean National Health and Nutrition Examination Survey in 2008. BMD was measured using dual-energy x-ray absorptiometry. Postmenopausal women with histories of adolescent pregnancy had lower BMD of the total hip, femoral neck, and lumbar spine than did women without histories of adolescent pregnancy. Multivariate logistic regression analyses revealed that postmenopausal women with history of adolescent pregnancy were at increased risk of osteoporosis (odds ratio, 2.20; 95% CI, 1.12-4.30) compared with women without history of adolescent pregnancy after adjustments for age, body mass index, marital status, education level, household income, alcohol intake, smoking history, exercise, age at menarche, age at menopause, parity, hormone therapy use, intake of energy and calcium, and vitamin D level. Adolescent pregnancy may be a predictor of osteoporosis in postmenopausal women.

  12. Interpregnancy interval as a risk factor for postmenopausal osteoporosis.

    Science.gov (United States)

    Sahin Ersoy, Gulcin; Giray, Burak; Subas, Seda; Simsek, Ersin; Sakin, Onder; Turhan, Omer Talip; Bulut, Sadullah

    2015-10-01

    Bone mass loss associated with pregnancy and lactation is usually regained in the postpartum period. However, it is not known whether the bone loss is completely recovered in women with a shortened interpregnancy interval (IPI). The aim of this study was to analyze the effect of IPI and gynecological history on postmenopausal osteoporosis. The study was conducted among 537 postmenopausal women who were divided into two groups in accordance with the osteoporosis status. Prior to bone densitometry, the patients were questioned about reproductive history. Dual-energy X-ray absorptiometry was used to measure lumbar spinal, femur neck and total femoral bone mineral density. Association between IPI and postmenopausal osteoporosis was analyzed. The comparison of both groups according to the total duration of breastfeeding did not reveal a considerable variation (p=0.288). In the osteoporosis group the age and duration of menopause were found to be significantly higher (ppregnancy and IPI were notably lower in comparison to the controls group (posteoporosis (OR: 4.306; 95% CI, 1.684-11.01). This analysis confirmed that the occurrence of first pregnancy under 27 years of age conveyed a higher risk for osteoporosis, as well. Shortened IPI may have a detrimental effect on bone mineral density in postmenopausal age. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Osteopenia and osteoporosis in postmenopausal women. Assessment by radiogrammetric measurement

    Energy Technology Data Exchange (ETDEWEB)

    Celiktas, M.; Aikimbaev, K.S.; Soyupak, S.; Binokay, F. [Cukurova Univ., Balcali Hospital, Adana (Turkey). Dept. of Radiology; Kozanoglu, E. [Cukurova Univ., Balcali Hospital, Adana (Turkey). Dept. of Physical Medicine and Rehabilitation

    2002-11-01

    Purpose: To compare the ability of the medial cortical thickness ratio to the width of the second metacarpal bone at the midshaft (MCR) in discriminating patients as normal, osteopenic or osteoporotic. Material and Methods: MCR was calculated from radiographs of 120 postmenopausal women. By dual-energy X-ray absorptiometry, the mineral density was measured in the lumbar spine, the wrist and the femoral neck. Patients were grouped in accordance with the diagnostic criteria of WHO on the basis of t-scores. MCR values were compared with t-scores and the ability of the MCR technique in discriminating the patient groups was evaluated. Results: Analysis of radiogrammetric data revealed significant differences in MCR value between the 3 groups. The MCR was lower in patients with osteoporosis and osteopenia compared with the normal group. The mean value of MCR was also slightly lower in patients with osteoporosis than in those with osteopenia. Accuracy assessment (ROC analysis) of MCR in the discrimination of patients with osteoporosis showed that test accuracy was acceptable, but less accurate than spinal, wrist and femoral neck t-scores. Compared with t-scores, this test was found to fairly discriminate those with and without osteopenia. Conclusion: The MCR method can discriminate patients as osteoporotic or normal. However, it seems that the MCR method should not be used for decisions concerning treatment of osteoporosis because of its low accuracy and thereby a risk for misclassification. Bone mineral density osteoporosis osteopenia radiogrammetry.

  14. Anabolic Therapy for the Treatment of Osteoporosis in Childhood.

    Science.gov (United States)

    Ward, Leanne M; Rauch, Frank

    2018-06-01

    Numerous forms of osteoporosis in childhood are characterized by low bone turnover (for example, osteoporosis due to neuromuscular disorders and glucocorticoid exposure). Anti-resorptive therapy, traditionally used to treat osteoporosis in the young, is associated with further reductions in bone turnover, raising concerns about the long-term safety and efficacy of such therapy. These observations have led to increasing interest in the role of anabolic therapy to treat pediatric osteoporosis. While growth hormone and androgens appears to be relatively weak anabolic modulators of bone mass, emerging therapies targeting bone formation pathways (anti-transforming growth factor beta antibody and anti-sclerostin antibody) hold considerable promise. Teriparatide remains an attractive option that merits formal study for patients post-epiphyseal fusion, although it must be considered that adult studies have shown its effect is blunted when administered following bisphosphonate therapy. Mechanical stimulation of bone through whole body vibration therapy appears to be much less effective than bisphosphonate therapy for treating osteoporosis in children. New anabolic therapies which target important pathways in skeletal metabolism merit further study in children, including their effects on fracture risk reduction and after treatment discontinuation.

  15. Ontario FIT - From poster child to industry crisis

    International Nuclear Information System (INIS)

    Roeper, Uwe

    2011-01-01

    Ortech is a consulting firm that provides engineering services to investors and developers in planning and operating solar, wind and water projects. This study discusses the issues involved in the renewable energy Feed-in Tariff (FIT) program in Ontario. Initially hailed as the poster child of innovative renewable programs in North America, the FIT program has been under increasing attack from political parties, anti wind groups and legal suits. The reason was the negative media coverage of noise, birdlife and health effects. Criticism was first voiced over health concerns and lack of consultation. Local governments and the legislature debated these issues and began to split along political lines over them. The lack of public support was because there was insufficient effort put into creating public awareness. Boosting grass-roots support by creating awareness is a recommendation of the paper, which also emphasises the need for a win-win strategy when the government is involved. It can be concluded that the FIT program has gone from poster child to industry crisis but has provided several learning opportunities along the way.

  16. Don't Let Osteoporosis Slow You Down | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... has never let anything stop her from doing what she loves, and she wasn't about to let osteoporosis keep her off the dance floor. It's that kind of spirit that led the National Osteoporosis Foundation (NOF) to ...

  17. Utility of testing for monoclonal bands in serum of patients with suspected osteoporosis

    DEFF Research Database (Denmark)

    Abrahamsen, B.; Andersen, Ivan; Christensen, Susanne S.

    2005-01-01

    OBJECTIVE: To determine whether measuring monoclonal bands (M component) in serum should be part of the investigation of patients referred to osteoporosis clinics. DESIGN: Retrospective, cross sectional, observational study. SETTING: Referral centre for osteoporosis in a university hospital...

  18. Preventing and Treating Brittle Bones and Osteoporosis | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... Javascript on. Feature: Osteoporosis Preventing and Treating Brittle Bones and Osteoporosis Past Issues / Winter 2011 Table of ... at high risk due to low bone mass. Bone and Bone Loss Bone is living, growing tissue. ...

  19. Osteoporosis in Сhildren with Itsenko — Cushing Disease: Etiology, Pathogenesis, Diagnosis

    Directory of Open Access Journals (Sweden)

    M.O. Ryznychuk

    2016-03-01

    Full Text Available The review describes the etiology, pathogenetic mechanisms of osteoporosis in children with Itsenko — Cushing syndrome. The new methods for the diagnosis of osteoporosis in children were also analyzed.

  20. Gene expression analysis in human osteoblasts exposed to dexamethasone identifies altered developmental pathways as putative drivers of osteoporosis

    Directory of Open Access Journals (Sweden)

    Sadlier Denise M

    2007-02-01

    Full Text Available Abstract Background Osteoporosis, a disease of decreased bone mineral density represents a significant and growing burden in the western world. Aging population structure and therapeutic use of glucocorticoids have contributed in no small way to the increase in the incidence of this disease. Despite substantial investigative efforts over the last number of years the exact molecular mechanism underpinning the initiation and progression of osteoporosis remain to be elucidated. This has meant that no significant advances in therapeutic strategies have emerged, with joint replacement surgery being the mainstay of treatment. Methods In this study we have used an integrated genomics profiling and computational biology based strategy to identify the key osteoblast genes and gene clusters whose expression is altered in response to dexamethasone exposure. Primary human osteoblasts were exposed to dexamethasone in vitro and microarray based transcriptome profiling completed. Results These studies identified approximately 500 osteoblast genes whose expression was altered. Functional characterization of the transcriptome identified developmental networks as being reactivated with 106 development associated genes found to be differentially regulated. Pathway reconstruction revealed coordinate alteration of members of the WNT signaling pathway, including frizzled-2, frizzled-7, DKK1 and WNT5B, whose differential expression in this setting was confirmed by real time PCR. Conclusion The WNT pathway is a key regulator of skeletogenesis as well as differentiation of bone cells. Reactivation of this pathway may lead to altered osteoblast activity resulting in decreased bone mineral density, the pathological hallmark of osteoporosis. The data herein lend weight to the hypothesis that alterations in developmental pathways drive the initiation and progression of osteoporosis.